厚生省 DIC 診断基準を用いた DIC 診断における Global Test の評価 Evaluation of Global Test for the Diagnosis of DIC by the Criteria established by the Japanese Ministry of Health and Welfare

この論文にアクセスする

この論文をさがす

著者

抄録

造血器腫瘍375例, 非造血器腫瘍551例について, 厚生省播種性血管内凝固症候群 (DIC) 診断項目について検討した. 出血症状はDIC例の60%以上に見られ, 臓器症状は非造血器腫瘍群に高頻度に認められた. DIC例と非DIC例の比較では, PT比ならびにフィブリノゲン値は造血器腫瘍群, 非造血器腫瘍群ともに有意差 (P<0.001) を認めたが, 非造血器腫瘍群におけるFDP値の有意差は低かった (p<0.05). これは非造血器腫瘍群の非DIC例において高値を示す症例が多数見られたためである. DIC診断に対する感度はFDP値がもっとも高く, フィブリノゲン値がもっとも低かった. 一方, DIC診断に対する特異性はフィブリノゲン値がもっとも高く, FDP値がもっとも低かった. Receiver operating characteristic (ROC) 解析では, FDP値, PT比, 血小板数, フィブリノゲン値の順にDICの診断に有用であった. 以上の成績から, FDP値はカットオフ値を上げ, PT比はカットオフ値を下げることが感度や特異性の向上に有用であり, フィブリノゲン値のDIC診断に対する有用性は低いことが示唆された.

The criterion for the diagnosis of the disseminated intravascular coagulation syndrome (DIC) established by the Ministry of Health and Welfare of Japan was subjected for evaluation in patients with DIC associated with hematopoietic tumors (375) and non-hematopoietic tumors (551). Bleeding was frequent in the DIC group (>60%) and organ failures were frequently observed in the group of patients with non-hematopoietic tumors. Regardless of hematopoitic or non-hematopoitic tumors, differences of the prothrombin time (PT) ratio and those of plasma fibrinogen were found to be highly significant between the DIC and non-DIC patient groups (p<0,001). The difference of the fibrinogen/fibrin degradation products (FDP) between the two groups was only slightly significant, however (p<0,05), FDP appeared to be the highest but the plasma fibrinogen was the lowest in terms of the sensitivity for the diagnosis of DIC, whereas the plasma fibrinogen was the highest and FDP was the lowest in terms of its specificity. The receiver operating characteristic analysis showed that FDP, the PT ratio, platelet counts and plasma fibrinogen were useful for the diagnosis of DIC in this order. To elevate the cut-off value of FDP and to reduce that of the PT ratio thus seem to be more efficient for the diagnosis of DIC.

収録刊行物

  • 日本血栓止血学会誌 = The Journal of Japanese Society on Thrombosis and Hemostasis

    日本血栓止血学会誌 = The Journal of Japanese Society on Thrombosis and Hemostasis 12(3), 197-205, 2001-06-01

    The Japanese Society on Thrombosis and Hemostasis

参考文献:  19件中 1-19件 を表示

被引用文献:  9件中 1-9件 を表示

各種コード

  • NII論文ID(NAID)
    10008635877
  • NII書誌ID(NCID)
    AN10353762
  • 本文言語コード
    JPN
  • 資料種別
    ART
  • ISSN
    09157441
  • データ提供元
    CJP書誌  CJP引用  J-STAGE 
ページトップへ