@article{oai:niigata-u.repo.nii.ac.jp:00018116, author = {高橋, 芳右}, issue = {5}, journal = {新潟医学会雑誌, 新潟医学会雑誌}, month = {May}, note = {In disseminated intravascular coagulation (DIC), clinical and laboratory manifestations are extremely variable among patients, depending in most part on the underlying diseases. Patients with DIC caused by leukemia and vascular lesions show marked activation of fibrinolysis, resulting in the predominant bleeding tendency. In addition to the synthesis of procoagulant tissue factor, leukemic cells, especially acute promyelocytic leukemia cells, produce and secrete profibrinolytic plasminogen activators and leukocyte proteases, which would contribute to the excessive fibrinolysis seen in these patients. Patients with sepsis show relatively suppressed fibrinolysis and are frequently complicated by organ damage. Endotoxin, TNF and IL-1 stimulate the synthesis of tissue factor and plasminogen activator inhibitor-1, and decrease the expression of thrombomodulin and heparan sulfate in endothelial cells, which result in the predominant activation of coagulation and suppression of fibrinolysis. Intermediate profiles are observed in patients with solid cancer and malignant lymphoma. Since the pathogenesis and hemostatic profiles are thus variable among patients with DIC, management should be individualized for each patient.}, pages = {161--165}, title = {DICの病態の多様性}, volume = {110}, year = {1996} }