血管壁障害とDIC

抄録

The role of vascular injury in the development of DIC is evaluated by the analysis of clinicopathological and experimental studies. Among the 104 cases with disseminated intravascular coagulation (DIC), there were some patients whose pathogenesis of the development of DIC was thought to be closely related to the vascular injuries. In the cases of DIC with autoimmune deseases such as SLE, HUS, TTP and Goodpasture syndrome, the impairment of vascular structures was the prominent manifestation and combined deposition of immunoglobulin, complement and fibrin on the capillary vessel wall was demonstrated.
As for the animal model of vascular injury, acute diabetic ketoacidosis was made in rabbits by the intravenous injection of alloxan. The early stage of endothelial damages in the capillary vessels of the kidneys was demonstrated electron-microscopically and coagulation study of the animals also revealed hypercoagulability of the blood. Hypotension induced by exanguination resulted DIC only in the diabetic rabbits and not in normal control rabbits.
Besides activation of blood coagulation and vascular injury, stasis in the microcirculation was thought to be necessary for the development of DIC. These three mechanisms known as Virchow's triad are recognized as being prime importance in the etiology of DIC like as mentioned on the causes of classical the thrombosis.