The Elevation of Plasma Thrombomodulin in Patients with InfectiousDiseases, and its Relationship to Granulocyte Elastase and CoagulationParameters at the Early Phase of Infection

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概要

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• Objectives : The plasma thrombomodulin (TM) level is thought to be an indicator of endothelial cell damage. Plasma TM levels were measured along with other parameters in 153 patients with various infectious diseases. The clinical significance of plasma TM was assessed to evaluate the endothelial cell damage in infection. Design : A retrospective study of patients with infectious diseases. Setting : Out-patient and inpatient clinics at the hospital of the Niigata University School of Medicine and other hospitals. Patients : The patients' median age was 68 years. There were 95 patients with a respiratory tract infection, 10 with a biliary tract infection, 33 with a gastrointestinal infection, 8 with a urinary tract infection, and 7 with other infections. Patients having such complications as disseminated intravascular coagulation, diabetes mellitus, cerebrovascular disease, cancer, and renal dysfunction (serum creatinine>110μmolL^<-1>) or those undergoing anticoagulant therapy were excluded. Results : The plasma levels of TM, thrombin-antithrombin III complex (TAT), plasmin-α2-plasmin inhibitor complex (PIC), fibrin degradation products (FDP), crosslinked fibrin degradation products (D-dimer), fibrinogen, von Willebrand factor antigen (vWf : Ag) and granulocyte elastase-α1-proteinase inhibitor complex were elevated, and those of antithrombin III and protein C were decreased in these patients. The plasma TM correlated positively with the granulocyte counts, suggesting the participation of granulocytes in the endothelial cell damage. The plasma TM also correlated positively with PIC, FDP, D-dimer and vWf : Ag, and negatively with protein C. These changes were more marked in the older patients. Conclusions : Endothelial cell damage and the activation of blood coagulation and fibrinolysis were found in patients with infectious diseases.

• 新潟大学の論文

著者

• Aizawa Yoshiyasu

  神戸大学 医学部

• Aizawa Y

  Niigata Univ. Graduate School Of Medical And Dental Sci. Niigata Jpn

• Takahashi H

  First Department Of Internal Niigata University School Of Medicine

• Seki Y

  Niigata Univ. Jpn

• Seki Yoshinobu

  First Department Of Internal Medicine Niigata University

• Yoshinobu SEKI

  First Department of Internal, Niigata University School of Medicine

• Hoyu TAKAHASHI

  First Department of Internal, Niigata University School of Medicine

• Yoshifusa AIZAWA

  First Department of Internal, Niigata University School of Medicine

• Yoshifusa Aizawa

  First Department Of Ineternal Medicine Niigata Universityschool Of Medicine

• Aizawa Yoshifusa

  First Department Of Internal Medicine Niigata Universaity School Of Medicine

• TAKAHASHI Hoyu

  First Department of Internal, Niigata University School of Medicine

• AIZAWA Yoshifusa

  First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.

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