尿路感染症による播種性血管内凝固症候群に対する遺伝子組換えトロンボモジュリン製剤の有効性 : 遺伝子組換えトロンボモジュリン未使用症例との後ろ向き比較検討

Abstract

We examined the efficacy of recombinant thrombomodulin (rTM) for treatment of patients with disseminated intravascular coagulation (DIC) caused by urinary tract infections. Thirteen DIC patients treated with rTM (rTM group) and 11 not receiving rTM (non-rTM group) were enrolled in this study. Blood data including coagulation markers collected before and after the treatment, a hospitalized term, and period of antibiotic treatment were compared. There were no significant differences in baseline characteristics between the two groups. Both groups showed significant improvement in all parameters such as blood biochemical data, coagulation markers, and DIC score 5-7 days after treatment. However, changes in platelet and DIC score from baseline to early phase (day 1-3) were significantly greater in the rTM group than in the non-rTM group (p＜0.05). In addition, changes in FDP value showed slight but not significant improvement in rTM group compared to the non-rTM group in the early treatment phase (p＝ 0.084). The period of antibiotic usage was significantly shorter in the rTM group, whereas the hospitalized term showed no significant difference between the groups. Definite adverse effects were not present in the rTM group. In conclusion, administration of rTM may have a beneficial effect in patients with DIC induced by urinary tract infections, compared with conventional treatment.