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首页> 外文期刊>Open access Emergency Medicine >Management of disseminated intravascular coagulation: current insights on antithrombin and thrombomodulin treatments
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Management of disseminated intravascular coagulation: current insights on antithrombin and thrombomodulin treatments

机译：弥散性血管内凝血的管理：抗凝血酶和血栓调节蛋白治疗的最新见解

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摘要

Sepsis and septic shock are frequently complicated by disseminated intravascular coagulation (DIC), which decreases the survival rate of patients with sepsis. In the past, large international randomized controlled trials (RCTs) using physiological anticoagulants for sepsis-induced DIC were not performed; however, RCTs have been conducted for sepsis and/or septic shock. In these trials, physiological anticoagulants did not show any beneficial effects compared with placebo for the treatment of sepsis and/or septic shock. In Japan, DIC treatments using antithrombin (AT) and/or recombinant human soluble thrombomodulin (rhTM) are common for patients with sepsis-induced DIC. Recently, large propensity score analyses demonstrated that AT and rhTM improved survival in patients with sepsis-induced DIC. Furthermore, post hoc analyses and meta-analyses that selected patients with sepsis-induced DIC from the previous large international RCTs indicated that physiological anticoagulants improved survival without increasing the associated sepsis-induced DIC bleeding. DIC treatments, such as AT and rhTM, may demonstrate beneficial effects when they are targeted at patients with sepsis-induced DIC only.
机译：败血症和败血性休克常伴随弥散性血管内凝血（DIC）并发，这降低了败血症患者的生存率。过去，并未进行使用生理性抗凝剂治疗败血症诱发的DIC的大型国际随机对照试验（RCT）;然而，已经针对败血症和/或败血性休克进行了RCT。在这些试验中，与安慰剂相比，生理性抗凝剂对败血症和/或败血性休克的治疗没有任何有益作用。在日本，败血症诱导的DIC患者通常使用抗凝血酶（AT）和/或重组人可溶性血栓调节蛋白（rhTM）进行DIC治疗。最近，大量倾向评分分析表明，AT和rhTM可改善败血症诱导DIC患者的生存率。此外，事后分析和荟萃分析从以前的大型国际RCT中选择了败血症诱导的DIC患者，结果表明，生理性抗凝剂可改善生存率，而不会增加败血症诱导的DIC出血。当仅针对败血症诱导的DIC患者时，诸如AT和rhTM之类的DIC治疗可能显示出有益的效果。

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