最近の血液検査(4)

DIC の凝固検査異常

和　田　英　夫*
　　　　　　　　　　　　　　　　　　　　　　
Hemostatic Abnormalities in DIC

Hideo WADA, MD*

There are global coagulation tests and hemostatic molecular markers in the diagnosis of disseminated intravascular coagulation(DIC). In the global coagulation tests, the sensitivity of prothrombin time ratio and fibrinogen for the diagnosis of DIC is low, but their specificity is high. In platelet count and FDP, the sensitivity for the diagnosis of DIC is good, but the specificity is low. Fibrinogen may be unsuitable for the diagnosis of DIC, because it increases of the inflammatory reaction. It is possible to theoretically diagnose DIC by increased tissue factor production. It is currently considered that hemostatic molecular marker should be utilized to diagnose DIC. Thrombin-antithrombin complex and soluble fibrin are reflected to hypercoagulable state, thrombomodulin to vascular endothelial cell injuries, and plasminogen activator inhibitor-I to hypofibrinolytic state. In leukemia with DIC, hyperfibrinolysis and marked bleeding symptoms are often observed. In septicemia with DIC, hypofibrinolysis and severe organ failure often occur. Early diagnosis and treatment of DIC are important to improve the prognosis, and hemostatic molecular markers should be useful for that purpose.
[Rinsho Byori 50 : 768〜772, 2002]

*Department of Laboratory Medicine, Mie University School of Medicine, Tsu 514-8507

【Key Words】DIC(播種性血管内凝固症)，hemostatic molecular marker(止血系分子マーカー)，global coagulation tests(グローバル止血系マーカー)，pre-DIC(早期DIC)，outcome(予後)

*三重大医学部臨床検査医学(〒514-8507 津市江戸橋2-174)

E-mail :wadahide@clin.medic.mei-u.ac.jp