抄録
The clinical significance of the mesurements of fibrinogen (fbg)-derivatives and other parameters related to coagulation and fibrinolysis in the diagnosis of disseminated intravascular coagulation (DIC) was studied. One hundred six patients (41 with DIC and 65 with non-DIC diseases) and 341 healthy subjects were studied. In the DIC patients, the plasma levels of high molecular weight fibrin (HMW-fbn), soluble fibrin monomer complex (sfmc), fibrinopeptide A (FPA) and FDP family were significantly higher than in the healthy subjects. However, fbg concentration was not significantly different between these 2 groups. In the serial mesurements of various parameters in 8 DIC patients, the plasma levels of HMW-fbn, SFMC and FDP family were observed to increase progressively from the pre-DIC stage to the DIC stage, but fbg concentration, platelet counts, and the activities of prothrombin, antithrombin III, plasminogen and α2 plasmin inhibitor were progressively decreased. The most of pre-DIC patients (70% or more of the cases) showed the abnormal levels of SFMC, FPA, FDP-D, E1 E2 and FDP-E.
In conclusion, for the early diagnosis of the pre-DIC and DIC, the serial measurements of the following parameters were considered to be especially important; SFMC or FPA as the indicator of hypercoagulability state, and FDP-D, E1 E2 or FDP-E as of hyperfibrinolytic state.
