Abstract
To assess the combination effect of a genetic recombinant human soluble thrombomodulin (rTM) with conventional therapy on the treatment of disseminated intravascular coagulation (DIC), we conducted a comparative retrospective study of coagulation fibrinolysis, vascular endothelial damage, organ damage and mortality rate after 90 days among 17 patients with septic DIC treated with combination of rTM with conventional therapy (rTM group) and 16 patients treated with conventional therapy alone (non-rTM group). In the rTM group, a comparison between findings obtained on day 1 and day 7 of administration showed statistically significant decreases in the levels of soluble fibrin (P = 0.039) and E-selectin (P = 0.044), the DIC score (P = 0.017) and the Sequential Organ Failure Assessment (SOFA) score (P = 0.03), which were used to evaluate therapeutic efficacy, but no significant decreases were observed in the non-rTM group. On day 7 of administration, the plasminogen activator inhibitor-1 (PAI-1) level in the patients treated with the rTM was significantly lower than in the untreated patients (P = 0.025). A survival analysis did not show a significant difference between the two groups, but the results suggested a tendency toward a higher survival rate in the rTM group (P = 0.064). The results of our study suggested that treatment of combination of rTM with conventional therapy may have yielded considerable benefits to the treatment of septic DIC.
