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Published on: September 9, 2012
Relationship between disseminated intravascular coagulation and levels of plasma thrombinogen segment 1+2, D-dimer,
1Department of Trauma Sugery, Research Institute of Surgery, Daping Hospital, Third Military Medical University, Chongqing, China. zhuyujun@yahoo.cn
Insights
Plasma thrombinogen segment 1+2 (F1+2), D-dimer (D-D), and thrombomodulin (TM) levels increase with trauma severity and correlate with disseminated intravascular coagulation (DIC). These markers may predict DIC occurrence in trauma patients.
Area of Science:
- Trauma research
- Coagulation science
- Biomarker discovery
Background:
- Disseminated intravascular coagulation (DIC) is a severe complication following major trauma.
- Early detection and prediction of DIC are crucial for patient management.
- Specific biomarkers may indicate the activation of coagulation pathways in trauma patients.
Purpose of the Study:
- To investigate the relationship between plasma levels of thrombinogen segment 1+2 (F1+2), D-dimer (D-D), and thrombomodulin (TM) and the development of DIC in patients with severe multiple injuries.
- To assess the potential of these markers in predicting posttraumatic DIC.
Main Methods:
- A cohort of 66 severely injured patients was classified into minor (ISS<16) and major (ISS≥16) injury groups.
- Major injury patients were further divided into DIC and non-DIC subgroups.
- Plasma F1+2, D-D, and TM levels were measured using ELISA and latex enhanced immunoassay at multiple time points post-trauma.
- A control group of 10 healthy individuals was included for comparison.
Main Results:
- F1+2, D-D, and TM levels were significantly elevated in both minor and major injury groups compared to controls, and higher in the major injury group.
- In DIC patients, F1+2 and D-D remained elevated, while TM showed an initial rise followed by a decrease.
- Plasma F1+2, D-D, and TM levels were higher in the DIC subgroup than in the non-DIC subgroup and positively correlated with each other.
Conclusions:
- Plasma F1+2, D-D, and TM levels are closely associated with trauma severity and the occurrence of posttraumatic DIC.
- Changes in these plasma markers may serve as predictive indicators for the development of DIC following severe trauma.
Objective:
To explore the relationship between disseminated intravascular coagulation (DIC) and levels of plasma thrombinogen segment 1+2 (F1+2), D-dimer (D-D), and thrombomodulin (TM) in patients with severe multiple injuries.
Methods:
In this study, 66 patients (49 males and 17 females, aged 15-74 years, mean=38.4 years) with multiple injuries, who were admitted to our hospital within 24 hours after injury with no personal or family history of hematopathy or coagulopathy, were divided into a minor injury group (ISS<16, n=21) and a major injury group (ISS>or=16, n=45) according to the injury severity. The patients in the major injury group were divided into a subgroup complicated with DIC (DIC subgroup, n=12) and a subgroup complicated with no DIC (non-DIC subgroup, n=33). Ten healthy people (7 males and 3 females, aged 22-61 years, mean=36.5 years+/-9.0 years), who received somatoscopy and diagnosed as healthy, served as the control group. Venous blood samples were collected once in the control group and 1, 3 and 7 days after trauma in the injury groups. The F1+2 and TM concentrations were determined by enzyme linked immunosorbent assay (ELISA), and D-D concentrations were measured by automated latex enhanced immunoassay.
Results:
F1+2, D-D and TM levels were higher in the minor and major injury groups than in the control group. They were markedly higher in the major injury group than in the minor injury group. In the non-DIC subgroup, F1+2 levels declined gradually while D-D and TM levels declined continuously. In the DIC subgroup, F1+2 and D-D levels remained elevated while TM levels exhibited an early rise and subsequent decrease. Plasma F1+2, D-D and TM levels were higher in the DIC patients than in the non-DIC patients. Injury-induced increases in F1+2, D-D and TM plasma levels had significant positive correlation with each other at each time point.
Conclusions:
Besides being related to trauma severity, F1+2, D-D and TM levels correlate closely with the occurrence of posttraumatic DIC. Therefore, changes in plasma F1+2, D-D and TM levels may predict the occurrence of DIC.
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