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Treatment effect of thrombomodulin-α on septic disseminated intravascular coagulation (DIC): a historical cohort study
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- Kudo Daisuke
- Emergency Center, Tohoku University Hospital
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- Shinozawa Yotaro
- Department of Emergency Medicine, International University of Health and Welfare Hospital
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- Yamanouchi Satoshi
- Emergency Center, Tohoku University Hospital
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- Endo Tomoyuki
- Emergency Center, Tohoku University Hospital
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- Sato Takeaki
- Emergency Center, Tohoku University Hospital
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- Furukawa Hajime
- Emergency Center, Tohoku University Hospital
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- Nomura Ryosuke
- Emergency Center, Tohoku University Hospital
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- Kushimoto Shigeki
- Emergency Center, Tohoku University Hospital
Bibliographic Information
- Other Title
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- 敗血症性disseminated intravascular coagulation(DIC)に対するトロンボモジュリンアルファの治療効果:ヒストリカルコホート研究
- Treatment effect of thrombomodulin-^|^alpha; on septic disseminated intravascular coagulation (DIC): a historical cohort study
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Description
Objectives: Patients with sepsis complicated by disseminated intravascular coagulation (septic DIC) have poor outcomes. Thrombomodulin-α (TM-α) is marketed as an anti-DIC drug in Japan. It has been reported that TM-α has also anti-inflammatory effects on sepsis by neutralizing high mobility group box 1 (HMGB1) in basic researches. The aim of this study was to investigate treatment effects of TM-α in patients with septic DIC. Methods: A historical cohort study was performed in a single tertiary emergency center. Patients with septic DIC were classified based on the period of admission. In the TM-α group (n = 30), all patients with septic DIC received TM-α with or without synthetic protease inhibitors (sPI) and/or antithrombin (AT). In the non-TM-α group (n = 23), all patients received sPI and/or AT without TM-α. The primary endpoint was 30-day survival rate. Secondary endpoints included DIC resolution rate at day 7. Results: Demographics, severity of illness, and interventions other than anti-DIC drugs were similar between the groups. The TM-α group had a significantly higher 30-day survival rate compared with the non-TM-α group [90.0% (27/30) vs. 65.2% (15/23), P = 0.041]. In the TM-α and non-TM-α groups, DIC resolution rates were 50.0% (15/30) and 34.8% (8/23) (P = 0.268), respectively. The rate of change in HMGB1 was -48.1% (-66.1 to 97.0) in the TM-α group (n = 7) and 213% (-6.55 to 473) in the non-TM-α group (n = 6) (P = 0.086). The rate of change in interleukin-6 (IL-6) was similar between the groups. Conclusion: TM-α had a positive treatment effect in patients with septic DIC as assessed by 30-day survival rate. The mechanism of this effect may not only be through anti-DIC action, but also an anti-inflammatory effect through reduction of HMGB1
Journal
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- Journal of the Japanese Society of Intensive Care Medicine
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Journal of the Japanese Society of Intensive Care Medicine 19 (3), 359-366, 2012
The Japanese Society of Intensive Care Medicine
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Keywords
Details 詳細情報について
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- CRID
- 1390001204444088832
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- NII Article ID
- 130004514411
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- ISSN
- 1882966X
- 13407988
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- Text Lang
- ja
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- Data Source
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- JaLC
- Crossref
- CiNii Articles
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- Abstract License Flag
- Disallowed