[Coagulation dysfunctions in patients with systemic inflammatory response syndrome].

OBJECTIVE: To study the effects of coagulation dysfunctions on patients with the development of systemic inflammatory response syndrome (SIRS). METHODS: All the patients studied were divided into 2 groups: SIRS and non-SIRS according to the criteria for selection of SIRS. The SIRS group included 100 patients and the non-SIRS group 50 patients. A control group included 50 healthy adults. SIRS group was further divided into two subgroups: survivor and non-survivor. Levels of platelet (PLT), D-dimer, protein C (PC), protein S (PS), antithrombin III (ATIII), thrombomodulin (TM), tissue plasminogen activator (TPA), plasminogen-activator inhibitor (PAI-1), prothrombin test (PT), thrombin time (TT), activated partial thromboplastin time (APTT) and fibrinogen (FBG) were measured in all the patients and healthy persons. RESULTS: (1) Levels of TT, APTT, PT, D-dimer, TM, PAI-1 were significantly higher in SIRS than those in non-SIRS and the control group (P < 0.05). Levels of PC, PS, TPA, PLT, FBG were significantly lower in SIRS group than those in non-SIRS and the control group (P < 0.05). (2) Levels of ATIII were not different among SIRS, non-SIRS and the control group (P > 0.05). (3) Survivors levels of D-dimer, APTT and PAI-1 in SIRS group were significantly higher than there in non-survivors (P < 0.05); they were both negatively correlated with the prognosis of SIRS (P < 0.01). CONCLUSIONS: (1) There are dysfunctions of coagulation in patients with systemic inflammatory response syndrome. (2) Fibrinolytic system plays an important role in the development of SIRS. (3) Levels of PAI-1 and D-dimer are both negatively correlated with the prognosis of SIRS.