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.