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KMID : 0384119930130040579
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Korean Journal of Clinical Pathology
1993 Volume.13 No. 4 p.579 ~ p.586
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Clinical Usefulness of Thrombin-Antrthrombin III(TAT) Complex for the Diagnosis of Disseminated Intravascular Coagulation (DIC) in Liver Cirrhosis
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Abstract
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It is difficult to diagnose disseminated intravascular coagulation (DIC) in liver disease frequently accompanying decreased synthesis of coagulation factor and decreased clearance of fibrinolytic activator. Recently thrombin-antithrombin III
(TAT)
complex test has been introduced as a direct indicator of in vivo generation of thrombin and is elevated in patients with DIC. We measured TAT complex in 28 healthy controls and 35 patients with liver cirrhosis. Patients were classified into
non-DIC
(n=25), pre-DIC (n=2), and (n=8) groups according to the scoring system including clinical signs (bleeding, organ dysfuction) and screening tests (platelet count, prothrombin time, fibrinogen, fibrinogen degradation product). The reference range
of
TAT
from healthy controls (n=28) was 0.66-5.27 ng/mL (mean±2SD). TAT values were significantly increased in pre-DIC and DIC groups compared to healthy control group(p<0.001). There were no significant correlations between TAT and other DIC
parameters.
The
presence of ascites did not affect the TAT values statistically. The sensitivity, specificity, positive predictive value, negative predictive value and overall diagnostic efficacy of TAT test for the diagnosis of DIC in liver cirrhosis were 80%,
92%,
80%, 92% and 88.6%, respectively, at the diagnostic level of 5.27 ng/mL(mean+2SD). In conclusion, TAT test is thought to be a sensitive and specific parameter of thrombin generation even when hepatic dysfunction is present. This assay seems to be
useful
in the diagnosis of DIC in patients with liver cirrhosis.
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KEYWORD
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