DICの診断基準と血液凝固検査の標準化(2)

プロトロンビン時間(PT)と標準化
INR 表記法を DIC 診断基準に適応できる可能性について

香　川　和　彦*1　福　武　勝　幸*2
　　　　　　　　　　　　　　　　　　　　　　
Prothrombin Time and Its Standardization：A Potentiality to Introduce INR Method in Criteria for Disseminated Intravascular Coagulation

Kazuhiko KAGAWA, MD, PhD*1 and Katsuyuki FUKUTAKE, MD, PhD*2

Prothrombin time(PT) is widely utilized for evaluation of diseases with single or multiple coagulation factors disorders, such as severe liver dysfunction and disseminated intravascular coagulation(DIC). However, its standardization of reagent and method is not established yet for universal purpose except International Normalized Ratio(INR) for control of oral anticoagulant therapy(OAT). Neither Prothrombin time ratio adapted in Japanese criteria for DIC nor seconds method in criteria reported by the last SSC meeting is corrected between assays, therefore much dependence on these criteria causes risk of misdiagnosis.
In order to resolve incoherence of method of PT, we performed this study for introducing INR method to diagnostic criteria for DIC. In our results, sensitivities of two reagents from human tissue factor(TF) to DIC model plasma with middle to low activities of multiple coagulation factors almost equal to plasma from patients with OAC, although other two reagents from rabbit TF show discrepancy of sensitivities between DIC and OAT plasma.
These suggest a potentiality to introduce INR system to diagnosis of DIC when human TF is used as a PT reagent. Based on standardization of method, significance of PT in DIC criteria should be re-evaluated in worldwide.
[Rinsho Byori 50 : 277〜282, 2002]

*1Department of Laboratory Medicine, Tokyo Medical University Shinjyuku-ku, Tokyo 160-0023

【Key Words】prothrombin time(プロトロンビン時間)，international normalized ratio : INR，disseminated intravascular coagulation(播種性血管内凝固)，standardization(標準化)

*1,2東京医科大学臨床検査医学講座(〒160-0023 東京都新宿区西新宿6-7-1)

E-mail :kazz@tokyo-med.ac.jp