Nihon rinsho. Japanese journal of clinical medicine
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Pathophysiology of DIC varies with underlining diseases but its precipitating factor is accepted to be mainly as an accerelation of blood coagulation. From these back grounds it is indicated that the removal of the original pathogenetic factor is important as the first step of treatment, and at the same time the anticoagulant treatment has been also advised as a fundamental remedy against this disease state. ⋯ However their beneficial effects or efficasies have not been established yet. This paper reports the pharmacological properties of these anticoagulants and some data of their clinical evaluations.
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Despite of many investigations addressing the problem on the diagnosis of DIC associated with liver diseases, however, an adequate clinical and laboratory criteria has not yet been established. We attempted to clarify this problem by evaluating the changes of plasma levels of PIC, D dimer, TAT and several endothelial factors in 20 patients with severe liver disease who had the evidence of hemorrhage, and were treated with AT III concentrate and gabexate mesilate (FOY). In patients who show a good response to treatment, plasma levels of PIC and D dimer before treatment were both significantly higher (p < 0.01) than those in patients who did not respond, while there was no significant difference in other coagulation fibrinolysis parameters except for platelet count which showed rather lower in the response group (p < 0.05). We believe that combination assay for both PIC and D dimer will be adequate to differentiate whether the hemostatic abnormalities are induced mainly by DIC or hepatic insufficiency.