Significance of measuring whole blood tissue factor activity in the diagnosis of disseminated intravascular coagulation / 中华急诊医学杂志

ABSTRACT

Objective To evaluate the significance of TF-PCA to the diagosis of DIC by observing changes of tissue factor(TF) and procoagulant activity (PCA) in patients with disseminated inravaascular coagulation(DIC)according to the enhancenment degree of whole blood leukocyte-derived TF expression and TF-PCA stimulated by Lipopolysaccharide (LPS). Method Patients with acute leukemia (AL) were included during hospitalization from Jan. 2005 to Jan. 2007 in Union Hospital of Huazhong University of Science and Technology. Recalcification time of LPS-stimulated whole blood was applied to evaluate tissue factor clotting time (TiFaCT) anticoagulated whole blood was incubated at 37°C for a certain time with or without LlS-stimulation, and then the recalcitication time was measured. TF-PCA were evaluated based on the decreased degree of whole blood mcalcification time(△s).LSI)- t test and bivariate correlation analysis were analyzed by using the SPSS software package (version 13.0 for Windows). A P-value less than 0.05 was considered statistically significant. Results A retrospective and contrast analysis indicated that △s in patients with DIC and patients suspected with DIC were (95.2±68.6) and (85.8±16.9), respectively. When compared with normal controls(30.4±25.1 ), the difference both had extremely statistical significe(P<0.01). The results of TF mRNA detection and TF-PCA inhibitory experiments showed that the method of TiFaCT had a high sersitivity and specificity for determination of TF-PCA. Condusiots The levels of TF-PCA were obviously elevated after stimulated by LPS in patients with DIC or suspected with DIC.TiFaCT has an important clinical reference value for the diagnostic and prognostic evaluation of DIC.