DISORDER OF COAGULATION-FIBRINOLYSIS SYSTEM IN PATIENTS WITH SEVERE ACUTE PANCREATITIS

重症急性膵炎における血液凝固線溶系の異常をretrospectiveに検討した．自験例では入院時から凝固線溶系の異常が高率に認められた．特にThrombin-antithrombin III complex（TAT）とD-dimerの異常発現率は100%であった．厚生労働省重症度スコアとの相関関係はProthrombin time-international normalized ratio（PT-INR）とTATが正の相関関係を，血小板が負の相関関係を示した．また，入院時TATはStage 2よりもStage 3, 4において高値を示した．生存群に比して死亡群において，PT-INRは有意に延長し，TATは高値を示した．入院時PT-INRが1.15以上の症例や入院時TATが45ng/ml以上の症例では死亡率が有意に高かった．以上より，重症急性膵炎において入院時TATは重症度や予後予測のマーカーとして有用である可能性が示唆された．

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