소아 파종성 혈관내 응고증에서 Antirhrombin III의 ㅣ치료효과

Abstract

The purpose of this study is to evaluate the clinical effect of antithrombin Ⅲ and to compare their outcomes with effect of conventionally used gabexate mesilate in disseminated intravascular coagulation(DIC) patients. From January 1992 to September 1993, 23 patients who were admitted to the Pediatric Department of Severance Hospital under the diagnosis of DIC were given antithrombin Ⅲ or gabexate mesilate for 3 days with monitoring the antithrombin blood level. The coagulation tests and clinical results were as follows : 1) The causative diseases of DIC were mainly infections and hematologic diseases. Sepsis was the leading cause of infections(34.8%) followed by pneumonia and urinary tract infection. Leukemia was the main part of hematologic diseases. 2) There were no differences in the hematologic laboratory findings between the two groups before the treatment. After 3 days of treatment, antithrombin Ⅲ level were significantly higher in antithrombin Ⅲ treated group compared to gabexate mesilate treated group(p<0.05). Fibrinogen and fibrin degradation products and DIC score showed some improvements in antithrombin Ⅲ treated group compared to gabexate mesilate treated group, but there were no statistical significnace. 3) After 12 hours of treatment, antithrombin Ⅲ treated group began to show significant improvement in antithrombin Ⅲ level compared to gabexate mesilate treated group(p< 0.05). 4) There were 7 out of 13(15.4% ) from antithrombin Ⅲ treated group and 4 out of 12(33.3%) from gabexate mesilate treated group improved from DIC. In conclusion, antithrombin Ⅲ treated group showed earlier normalization of antithrombin Ⅲ level which could be the effect of the prevention of thrombus formation and produce better improvements in DIC treatment in children.