Abstract:
INTRODUCTION:To evaluate the pathogenetic role of tissue factor (TF), tissue factor pathway inhibitor (TFPI), and neutrophil elastase in acute respiratory distress syndrome (ARDS), as well as to test the hypothesis that TFPI levels modified by neutrophil activation are not sufficient to prevent TF-dependent intravascular coagulation, leading to sustained systemic inflammatory response syndrome (SIRS) and multiple organ dysfunction syndrome (MODS), which determine the prognosis of these patients. MATERIALS AND METHODS:The study subjects consisted of 55 patients with trauma and sepsis who were divided into three groups according to the Lung Injury Score. Ten normal healthy volunteers served as control. Plasma levels of TF, TFPI, and neutrophil elastase were measured on the day of injury or the day of diagnosis of sepsis (day 0) and days 1 through 4. The number of SIRS criteria that the patient met and the disseminated intravascular coagulation (DIC) score is determined daily. RESULTS:Patients (15) developed ARDS, 23 were at risk for but did not develop the syndrome, and 17 patients were without risk for ARDS. TF and neutrophil elastase levels in ARDS patients were persistently higher than those in other two groups and control subjects. However, the TFPI levels showed no difference among the three groups, which retained normal or slightly elevated levels compared to the control subjects. DIC scores did not improve and SIRS continued during the study period in patients with ARDS. The ARDS patients showed higher numbers of dysfunctioning organs and associated with poorer outcome than the other two groups. CONCLUSION:Systemic activation of the TF-dependent pathway not adequately balanced by TFPI is one of the aggravating factors of ARDS. High levels of neutrophil elastase released from activated neutrophils may explain the imbalance of TF and TFPI. Persistent DIC and sustained SIRS contribute to MODS, determining the prognosis of ARDS patients.
journal_name
Thromb Resjournal_title
Thrombosis researchauthors
Gando S,Kameue T,Matsuda N,Hayakawa M,Morimoto Y,Ishitani T,Kemmotsu Odoi
10.1016/s0049-3848(03)00151-8subject
Has Abstractpub_date
2003-01-25 00:00:00pages
119-24issue
2-3eissn
0049-3848issn
1879-2472pii
S0049384803001518journal_volume
109pub_type
临床试验,杂志文章abstract::Severe bleeding took place in a patient when abdominal aneurysm was removed by operation. Bleeding continued after infusion of heparin, antithrombin III (ATIII), fresh platelets and fresh blood. Infusion of tranexamic acid resulted in an immediate cessation of bleeding and improvement of his general condition. Sometim...
journal_title:Thrombosis research
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journal_title:Thrombosis research
pub_type: 杂志文章
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2007.12.023
更新日期:2008-01-01 00:00:00
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journal_title:Thrombosis research
pub_type: 临床试验,杂志文章
doi:10.1016/s0049-3848(96)00207-1
更新日期:1996-12-15 00:00:00
abstract::We compared the effects of dipyridamole, RA-642, and mopidamol on platelet activity and thromboxane/prostacyclin balance in relation to the degree of retinal vascularization in a model of experimental streptozotocin-induced diabetes in rats. After 3 months, collagen-induced platelet aggregation in whole blood was 25% ...
journal_title:Thrombosis research
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journal_title:Thrombosis research
pub_type: 临床试验,杂志文章
doi:10.1016/j.thromres.2004.04.008
更新日期:2004-01-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章,评审
doi:10.1016/j.thromres.2014.11.034
更新日期:2015-02-01 00:00:00
abstract::Recombinant forms of human antithrombin (AT) were expressed in COS-1 cells, and their interaction with human thrombin characterized by comparing the reactivity of two engineered mutant forms of AT with the wild-type recombinant. Both mutant forms contained single amino acid substitutions of Asp (G392D) or Pro (G392P) ...
journal_title:Thrombosis research
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journal_title:Thrombosis research
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journal_title:Thrombosis research
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2007.02.001
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journal_title:Thrombosis research
pub_type: 临床试验,杂志文章
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更新日期:2003-01-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(84)90256-1
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journal_title:Thrombosis research
pub_type: 杂志文章,meta分析
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更新日期:2016-03-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(90)90105-l
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pub_type: 杂志文章
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更新日期:2010-04-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(82)90192-x
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pub_type: 杂志文章
doi:10.1016/j.thromres.2008.11.010
更新日期:2009-05-01 00:00:00
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pub_type: 杂志文章
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pub_type: 杂志文章
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pub_type: 临床试验,杂志文章
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pub_type: 杂志文章
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journal_title:Thrombosis research
pub_type: 杂志文章,评审
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更新日期:2016-05-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/0049-3848(85)90150-1
更新日期:1985-05-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2006.11.009
更新日期:2007-01-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
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更新日期:2000-09-15 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
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更新日期:1988-01-01 00:00:00
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journal_title:Thrombosis research
pub_type: 杂志文章
doi:10.1016/j.thromres.2012.09.002
更新日期:2012-12-01 00:00:00
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pub_type: 杂志文章
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