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Disseminated intravascular coagulation caused by what?
Cause of DIC caused by many, according to internal analysis of a set of materials to infection is common, accounting for the total incidence of 1 / 3, followed by malignancies (including acute promyelocytic leukemia included) combined with the accounting cause of the 2 / 3, extensive surgery, tissue injury, obstetric accidents occurred during cardiopulmonary bypass, also are common causes of DIC.
Occurrence of various causes not identical to the pathogenesis of DIC, the main mechanism of several causes DIC as follows:
(A) infection of Gram-negative and-positive bacteria can cause sepsis, but gram-negative bacteria is more common, such as E. coli, Proteus, Pseudomonas, Bacillus and other injuries, Gram-positive bacteria such as Staphylococcus staphylococcus, typhoid bacilli, Gram-positive bacteria such as Staphylococcus aureus, hemolytic streptococcus, Clostridium and other, non-rare bacterial infection, such as viruses, Ehrlichia, protozoa, spirochetes and fungi infection, the incidence of bacterial infections, including bacterial infection itself, the main factors and the resulting endotoxin, bacterial infection, endothelial cell damage, can release large amounts of tissue factor into the blood, promoting blood coagulation, complement on coagulation, fibrinolysis and kinin system activation is also a relationship, on the endotoxin, experiments have proved, as in the test tube will be gram-negative bacterial endotoxin in the blood can cause added monocytes produce the native membrane tissue factor activity, if the rabbit with plenty of class alkylating agent after the consumption of monocytes does not occur endotoxin DIC, endotoxin exposure to vascular endothelial cells also produce tissue factor activity, but also bacteria found in the leather-positive bacteria cell wall in Peptidogyciw (one kind of induced DIC Peptide sugar) and techoic acid ratio is also related to the occurrence of DIC, which shows DIC in the pathology caused by infection is complex, but also multifaceted, bradykinin relaxation of blood vessels have a strong role of infection caused by decreased blood pressure in and the reasons for occurrence of one shock.
(B) of the malignant tumor in the pancreas, kidney, prostate and bronchial cancer, etc., DIC more common, acute promyelocytic leukemia also easy to concurrent DIC, DIC in cancer is particularly likely in the transfer or a large number of broad cases of tissue necrosis, it is because in these cases, the tumor cells secrete large amounts of sticky protein, tissue factor, the former clotting substances, protein enzymes, can promote blood clotting and trigger the pathological role of DIC, Trousseau syndrome is a malignant tumor cases of chronic DIC, showed recurrent migratory venous thrombosis, or even starting performance.
(C) obstetric accidents, including amniotic fluid embolism, placental abruption, hypertonic saline abortion, toxemia of pregnancy, s
(D) other â‘ severe head injury with DIC may be due to the clotting activity of factors potentially through the destruction of blood-brain barrier into the blood circulation, promote blood clotting, â‘¡ snake bites cause DIC, after the release of tissue injury in addition large number of organizations factor into the blood to promote clotting, the secretion of substances in the venom itself, but also to fibrinogen into fibrin role, â‘¢ autoimmune diseases such as systemic lupus erythematosus, graft rejection reaction caused by DIC, the main exception is the disease Immune mechanism of widespread endothelial cell injury, complement activation mechanisms to promote clotting, â‘£ liver disease such as acute hepatic necrosis, cirrhosis and other serious cases of hepatic dysfunction, but also prone to DIC, the reasons are similar except for the above vascular endothelial damage and procoagulant effects, on the other hand the reason is due to liver disease in the uptake and clearance decreased procoagulant function, â‘¤ body temperature, acidosis, shock, hypoxia caused by vascular endothelial cells injury, can induce or aggravate DIC, hemolytic disease or hemolysis, the red blood cells can also trigger or aggravate procoagulant induced DIC.
In the pathogenesis of DIC in the most important change was due to both thrombin and plasmin consequences, the role of the two produced a number of in vivo coagulation and fibrinolysis matter, but also because of the role of two different causes , the priority of the severity of illness varies, but also not the same in the disease have different phase change through a series of laboratory tests to be found in the role of thrombin, the first is to break down the protein fibrinogen peptide A , the formation of fibrin monomer, monomer synthetic protein together with each other, and cross-linking factor â…¤ â…¢ role of thrombosis, but the fiber protein (the original) can also be split products and fibrin (FDP) to form soluble complexes, thrombin can also activate factor â…¤, â…§, â…© â…¢, protein C system and platelets, stimulate the production of a variety of active substances, such as media, platelet-activating factor (PAF), prostacyclin, VW factor, thrombin, vascular endothelial cells can also affect the fiber solvent system, so the body can cause changes in thrombin activity in vivo coagulation activity of biological substances on the changes, a result of its comprehensive fibrinogen, factor â…¡, â…¤, â…§, â…© â…¢, such as protein C and platelet consumption due to a large number of The decrease in platelet dysfunction, was originally in a variety of plasminogen activator, tissue plasminogen activator is also under the action of activated into plasmin, plasminogen act on fibrin (ogen) to form FDP / fdp, FDP could inhibit the formation and fibrin polymerization, platelet activation, coagulation factors can make the decomposition and inactivation of the fiber protein, factor â…¤, â…§, â…¨ the content decreased, the two effects from the above results, the DIC occurs when the body changes in coagulation and fibrinolysis is extremely complex.
In addition, in DIC, including reduction in the anticoagulant antithrombin â…¢, protein C system components, such as tissue factor pathway inhibitor.
Home> Experts> Content Document Name: ICU patients with disseminated intravascular coagulation and the clinical strategy causes 20 cases of Introduction: Objective To investigate the intensive care unit (ICU) patients with disseminated intravascular coagulation (DIC) of the causes and treatment strategies. Methods 2 0 cases of ICU patients, the reasons for occurrence of DIC and seek countermeasures. Results 20 cases, major surgery, post-traumatic shock and hemorrhage 12 patients, accounting for 60. 0%; 4 cases of malignant tumor, accounting for 20. 0%. Group of death group and non-fatal when the diagnosis of DIC were significantly different coagulation index (P Document Name ICU patients with disseminated intravascular coagulation and the clinical strategy causes 20 cases of Article Name
English (English) translation of Zhou Qing; Li Jianguo; Zhao-Hui Du; Author Author
Author Agencies Wuhan University Zhongnan Hospital intensive care unit; Zhongnan Hospital of Wuhan University, 430071 Wuhan intensive care unit; 430071 Wuhan; Document Source
Article From Shanghai Institute of Metallurgy; Materials Physics and Chemistry (Professional) PhD thesis in 2000 Keywords intensive care unit; disseminated intravascular coagulation; causes; countermeasures; Keywords
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