产科DIC18例治疗体会

目的:探讨产科DIC的诊治体会.方法:将2000年至2006年经我院救治的产科DIC18例作一总结分析.结果:18例中17例治愈,治愈率94.4%,15例行全子宫切除术,1例子宫破裂导致羊水栓塞诱发DIC抢救无效死亡,新生儿存活13例.结论:早期明确诊断,及时正确治疗对减少病死率至关重要.以抢救产妇的生命为主.及时终止妊娠.     

DIC的病理生理研究进展

DIC是一种源于微血管损伤并且可导致微血管损伤的获得性凝血紊乱综合征，不同的机制在止血系统的不同环节同时促使凝血活化，其中炎性介质和细胞因子的释放是其中心环节。     

Immunohistochemical Diagnosis of Disseminated Intravascular Coagulation in Newborns

Disseminated intravascular coagulation (DIC) and other clotting abnormalities are common in sick newborn infants who have a variety of conditions. To document evidence of DIC at autopsy, immunoperoxidase staining of fibrin-related antigens (FRA) was used to detect intravascular microthrombi in liver, kidney, and lung from 127 newborns. Patients were selected from seven major disease groups: hyaline membrane disease/bronchopulmonary dysplasia, infection, meconium aspiration, necrotizing enterocolitis, congenital heart disease, other congenital anomalies, and extreme prematurity. Staining for FRA in intravascular microthrombi was seen in 40% of cases studied. The liver showed the highest frequency of intravascular microthombri, located predominantly in the sinusoids. Unlike the adult kidney, the newborn kidney seldom had evidence of intravascular coagulation. Extravascular staining of FRA was observed in the renal distal tubular epithelium in 48 cases, many of which also had evidence of intravascular FRA staining. No significant differences in FRA staining patterns were seen among the disease groups except for cases of extreme prematurity in which all tissues showed minimal staining. Control tissues from SIDS patients also showed minimal FRA staining. Hepatic sinusoidal staining was the only tissue finding that correlated with thrombocytopenia, a clinical indicator of DIC. Despite the use of this immunohistochemical staining method, discrepancies between the clinical and autopsy diagnosis of DIC remain.     

Cerebral infarction in acute promyelocytic leukemia at initial presentation

We report on a 3 year old girl with acute promyelocytic leukemia (APL) with cerebral infarction due to disseminated intravascular coagulation (DIC) at initial presentation. She was hospitalized because of unconsciousness and petechiae on the chest wall and extremities. Cerebral ischemia and infarction were found on computed tomography scan and magnetic resonance imaging. Peripheral bood content was hemoglobin 7.3 g/dL, white blood cells 1.0 × 10³cells/μL (31% blasts) and platelet count was 12 × 10³cells/μL. Fragmented erythrocytes were frequently observed on May-Giemsa stained blood smears. Bone marrow aspirates showed normal cellularity, with 60.4% blasts, containing faggot cells. The blasts were positive for peroxidase. Therapy was begun; however, the patient died 1 week after admission.     

产科术中羊水栓塞合并DIC的救治1例体会

本文报道近15年来我院产科术中羊水栓塞合并DIC的救治经过与体会。1临床资料患者35岁,因滞产从乡镇医院转入我院行急症剖宫产手术。查生命体征正常,一般状态良好,实验室各项检查正常。入室常规经鼻导管吸氧,监测血压、脉博、呼吸、脉博血氧饱和度均正常。建立静脉通路,以乳酸林     

成分输血在抢救妇产科失血性休克并发DIC中的临床应用

目的：探讨成分输血在妇产科失血性休克并发弥散性血管内凝血（DIC）中的临床应用。方法：将2004年1月～2007年11月采用成分输血和输全血对本院妇产科失血性休克并发DIC 8例患者中应用的临床资料进行回顾性分析。结果：成分输血组在提高RBC、PCT、PT、APTT和FGB的改善等方面，均优于输全血组（P〈0.01，P〈0.05）。据临床及实验室确诊的8例DIC患者中，4例经成分输血，凝血功能均在24～72 h内恢复正常。而输全血的4例中，凝血功能均在32～86 h内恢复正常，其中有1例因阴道流血不止而行次全子宫切除术。结论：治疗产科失血性休克并发DIC，进行有效的成分输血，补充高浓度、高纯度的凝血因子，在短时间内使各种凝血因子达到有效的止血水平，以提高抢救的成功率，具有广泛的临床前景。     

白血病合并DIC的治疗体会

总结了１６例急性白血病合并ＤＩＣ患者的临床资料，除２例未治外，余均在化疗同时以肝素抗凝，ＤＩＣ痊愈６例，好转５例，有效率７８．５７％。化疗与抗凝在治疗中相辅相成。ＤＩＣ发生时，化疗不要停止，尽量完成疗程以解除原发病，缓解ＤＩＣ。在消耗性低凝期时，应用肝素时如ＫＰＴＴ明显延长，则需补充凝血因子。以试管法凝血时间延长１倍做为肝素化判断指标，一般勿需积极抗纤溶。ＤＩＣ缓解后肝素减量要慢。对于高白细胞型白     

Comparison of gene expression profiles between white and brown adipose tissues of rat by microarray analysis

To characterize the energy metabolism in brown adipose tissue (BAT), the differences in gene expression profiles between BAT and white adipose tissue (WAT) were analyzed using a high-density cDNA microarray. RNAs isolated from two adipose tissues were hybridized to an Agilent rat cDNA Microarray that contained about 14,500 cDNA probe sets. The expression levels of 499 cDNA/ESTs were found to be at least 5-fold higher or lower in BAT than in WAT. Consistent with our previous findings, high expression levels of genes encoding uncoupling protein 1, muscle-type carnitine palmitoyltransferase and some other proteins involved in energy metabolism in BAT were found. Most of the genes encoding mitochondrial proteins, such as subunits of ATP synthase, cytochrome c oxidase, and NADH dehydrogenase, were highly expressed, reflecting possible differences in the cellular content of mitochondria between BAT and WAT. However, the expression levels of several genes encoding mitochondrial protein, such as liver mitochondrial aldehyde dehydrogenase and dicarboxylate carrier, were remarkably lower in BAT. These results may give important clues to understand the unique energy metabolism in BAT.     

Effects of a Korean herbal formulation, Silsosangami, consisting of seven medicinal herbs, and its seven herbs on endotoxin-induced experimental thrombosis in rats

A traditional Korean medicine, Silsosangami (SSG), consisting of seven different herbs of Typhae Pollen, Pteropi Faeces, Paeoniae Radicis rubra, Cnidii Rhizoma, Persicae Semen, Carthami Flos and Curcumae Tuber, has been reported to have a hypolipidemic effect in human subjects. In the present study, the inhibitory effects of SSG on a thrombosis in rats, induced by endotoxin treatment were examined. The anti-thrombic properties of SSG were also investigated with respect to blood parameters. The extracts of SSG and five of the seven herbs, except Cnidii Rhizoma and Carthami Flos, inhibited both endotoxin-induced disseminated intravascular coagulation (DIC) and thrombosis in rats. The extract also inhibited the endotoxin-induced decrease in blood platelets and fibrinogen, and the endotoxin-induced increase in fibrin degradation products (FDP) on disseminated intravascular coagulation in normal rats. In conclusion, the artificially induced, protective effects of SSG on ischemic infarction might be related to their inhibitory effects on DIC, platelet coagulation and thrombotic action.     

恶性肿瘤晚期并发DIC临床分析

DIC较常见于恶性肿瘤晚期,其发生与肿瘤病人的内在因素及相关治疗密切相关。本文对临床发生的16例恶性肿瘤晚期合并DIC病人的发病及治疗情况做一下临床分析,以进一步探讨两者之间的关系。