INCREASED VASCULAR ENDOTHELIAL-CELL MARKERS IN PATIENTS WITH DISSEMINATED INTRAVASCULAR COAGULATION

We examined vascular endothelial cell markers, thrombomodulin (TM), pl asminogen activator inhibitor-I (PAI-I), tissue plasminogen activator (t-PA), and von Willebrand factor, in 80 patients with disseminated in travascular coagulation (DIC). The levels of thrombin-antithrombin III complex (TAT), plasmin-alpha2 plasmin inhibitor complex (PIC) and FDP -D-dimer were significantly increased both before and after the onset of DIC, but were not correlated with organ failure or prognosis. Howev er, the PIC/TAT ratio was lower in patients with poor prognosis than i n those with good prognosis, and it was also lower in those with organ failure than in those without. Plasma TM, PAI-I, and t-PA levels were increased in DIC patients with organ failure or poor outcome, but wer e not significantly increased before the onset of DIC. We consider tha t the prognosis of patients with DIC might be related to organ failure or endothelial cell damage and that plasma levels of TM, PAI-I, and t -PA might be useful in the detection of these disorders and in assessi ng prognosis. A hypofibrinolytic state might enhance organ failure in patients with DIC. (C) 1993 Wiley-Liss, Inc.