The Clinical Analysis Of 51 Patients With Acute DIC Caused By Three Kinds Common Etiology

Objective: To investigate the clinical characteristics of the patients with disseminated intravascular coagulation caused by infection, acute leukemia, pathological obstetric, and to study the positive rate of PLT, PT, APTT, Fg, TT, 3P, D-Dimer in DIC caused by different etiology whether have differences.To improve the level of knowledge and diagnosis for DIC. Methods: The data of clinical characteristics of 51 patients with DIC caused by infection or acute leukemia or pathological obstetric, from January 1998 to August 2008 in our hospital, were analyzed retrospectively and fifty-one patients with DIC were divided into infection group (22cases), acute leukemia group (15cases), Pathological obstetric group (14cases). The degree of hemorrhage, the rate of shock happened , The incidence of important organ damage , The incidence of microangiopathic hemolysis, efficacy, mortality, and the positive rate of PLT, PT, APTT, Fg,TT, 3P, D-dimer in patients with DIC caused by different etiology, were compared and analyzed with chi-square test and Kruskal-Wallis rank sum test. Results: There were statistical differences in the degree of hemorrhage , the rate of shock happened , The incidence of important organ damage, efficacy, mortality, positive rate of APTT among three groups (PO.001, PO.001, P=0.001, P=0.001, P=0.007, P=0.027).There were no statistical differences in the incidence of microangiopathic hemolysis, in positive rate of PLT, PT, Fg,TT,3P, D-dimer among three groups (P>0.05).There were statistical differences in the degree of hemorrhage,the incidence of important organ damage,efficacy and mortality, between infection group and acute leukemia group, between infection group and pathological obstetric group(P=0.013, P=0.001. P<0.001, P=0.006. P=0.008, P=0.001. P=0.013, P=0.006). There were statistical differences in the rate of shock happened between acute leukemia group and infection group, between acute leukemia group and pathological obstetric group (P<0.001, P=0.002). There were statistical differences in the positive rate of APTT between acute leukemia group and infection group (P=0.009).There were no statistical differences in the degree of hemorrhage, the incidence of important organ damage, efficacy, mortality between pathological obstetric group and acute leukemia group. There were no statistical differences in the rate of shock happened between pathological obstetric group and infection group. There were no statistical differences in the positive rate of APTT between acute leukemia group and pathological obstetric group, between pathological obstetric group and infection group (P>0.017). Conclusion: There are different clinical characteristics in patients with DIC caused by infection or acute leukemia or pathological obstetric.There are severe bleeding, few important organ damages and better efficacy and lower mortality in patients with acute leukemia-related DIC and pathological obstetric-related DIC than that with infection- related DIC.The rate of shock happened is high in patients with infection- related DIC. There are worse efficacy and higher mortality in patients with infection- related DIC because of more important organ damages than the others. It is more significant for diagnosis of DIC that the PLT, Fg, continuously declined. The positive rate of APTT is lower in patients with acute leukemia-related DIC than that with infection- related DIC. It may be related to that there are lower-level coagulation activated of intrinsic pathway or few heparin-like anticoagulants generated in bodies of patients with acute leukemia-related DIC, or related to a small number Sample. It need be confirmed in future.