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Abstract：
BACKGROUND: Sepsis typically results in enhanced coagulation system activation and microthrombus formation. Microparticle (MP) production promotes coagulation and enhances pro-coagulation. This study investigated how circulating MP levels and tissue factor-bearing MP (TF+-MP) activity caused coagulation in patients with septic disseminated intravascular coagulation (DIC).
METHODS: Thirty patients with septic DIC and 30 healthy controls were studied from December 2017 to March 2019. Patient blood samples were collected at enrolment (day 1) and on days 3 and 5; DIC scores and Sequential Organ Failure Assessment (SOFA) scores were recorded. TF+-MP activity was measured using TF-dependent factor Xa generation experiments. Circulating MP concentrations were determined by MP capture assay. Clotting factor activity, antithrombin level, soluble thrombomodulin, and serum tissue factor pathway inhibitor (TFPI) concentrations were measured.
RESULTS: Patients with septic DIC had lower circulating MP levels than healthy control patients. Circulating MP levels in patients with septic DIC were positively correlated with DIC scores and negatively correlated with coagulation factors, but TF+-MP activity did not correlate with clotting factor levels and TFPI.
CONCLUSIONS: In patients with septic DIC, circulating MP levels are important in promoting coagulation activation and increasing clotting factor consumption. TF+-MP activity may not be the main form of active TF.
METHODS: Thirty patients with septic DIC and 30 healthy controls were studied from December 2017 to March 2019. Patient blood samples were collected at enrolment (day 1) and on days 3 and 5; DIC scores and Sequential Organ Failure Assessment (SOFA) scores were recorded. TF+-MP activity was measured using TF-dependent factor Xa generation experiments. Circulating MP concentrations were determined by MP capture assay. Clotting factor activity, antithrombin level, soluble thrombomodulin, and serum tissue factor pathway inhibitor (TFPI) concentrations were measured.
RESULTS: Patients with septic DIC had lower circulating MP levels than healthy control patients. Circulating MP levels in patients with septic DIC were positively correlated with DIC scores and negatively correlated with coagulation factors, but TF+-MP activity did not correlate with clotting factor levels and TFPI.
CONCLUSIONS: In patients with septic DIC, circulating MP levels are important in promoting coagulation activation and increasing clotting factor consumption. TF+-MP activity may not be the main form of active TF.
摘要：
背景：脓毒症通常导致凝血系统激活和微血栓形成增强。微粒(MP)的产生促进凝固并增强促凝固。这项研究调查了败血症性弥散性血管内凝血（DIC）患者的循环MP水平和携带组织因子的MP（TF-MP）活性如何引起凝血。
方法：对2017年12月至2019年3月30例脓毒症DIC患者和30例健康对照进行研究。在登记时(第1天)和第3天和第5天收集患者血液样品;记录DIC评分和序贯器官衰竭评估(SOFA)评分。使用TF依赖性因子Xa生成实验测量TF+-MP活性。通过MP捕获测定确定循环MP浓度。凝血因子活性,抗凝血酶水平,可溶性血栓调节蛋白，测定血清组织因子途径抑制物(TFPI)浓度。
结果：脓毒症DIC患者的循环MP水平低于健康对照患者。脓毒症DIC患者循环MP水平与DIC评分呈正相关,与凝血因子呈负相关,但TF+-MP活性与凝血因子水平和TFPI无关。
结论：在脓毒症DIC患者中，循环MP水平在促进凝血激活和增加凝血因子消耗方面很重要.TF+-MP活性可能不是活性TF的主要形式。
方法：对2017年12月至2019年3月30例脓毒症DIC患者和30例健康对照进行研究。在登记时(第1天)和第3天和第5天收集患者血液样品;记录DIC评分和序贯器官衰竭评估(SOFA)评分。使用TF依赖性因子Xa生成实验测量TF+-MP活性。通过MP捕获测定确定循环MP浓度。凝血因子活性,抗凝血酶水平,可溶性血栓调节蛋白，测定血清组织因子途径抑制物(TFPI)浓度。
结果：脓毒症DIC患者的循环MP水平低于健康对照患者。脓毒症DIC患者循环MP水平与DIC评分呈正相关,与凝血因子呈负相关,但TF+-MP活性与凝血因子水平和TFPI无关。
结论：在脓毒症DIC患者中，循环MP水平在促进凝血激活和增加凝血因子消耗方面很重要.TF+-MP活性可能不是活性TF的主要形式。
