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の有効性

Efficacy of recombinant thrombomodulin for treatment of patients with disseminated intravascular coagulation caused by urinary tract infections

　尿路感染症（UTI）による播種性血管内凝固症候群（DIC）に対する遺伝子組換えトロンボモジュリン（rTM）の有効性について検討した．rTM投与12例（rTM群）とrTM非投与16例（非rTM群）で，治療前後の血算や凝固系マーカーの変化を後ろ向きに検討した．非rTM群では白血球数，血小板数およびCRP値が，rTM群ではCRP値とFDP値が有意に改善していた．非rTM群と比較してrTM群では，DICスコアが有意に改善していた．以上より，rTMはUTIによるDIC症例に対して，rTMを投与しない従来の治療法よりも同等以上の効果があると思われた．

Abstract

We examined the efficacy of recombinant thrombomodulin (rTM) for treatment of patients with disseminated intravascular coagulation (DIC) caused by urinary tract infections (UTI). Twelve DIC patients treated with rTM (rTM group) and 16 not receiving rTM (non-rTM group) were enrolled in this study. We retrospectively compared blood data including biochemical data and coagulation markers before and after the treatment. Among factors before the treatment, significant difference was noted in CRP between the groups (p < 0.05) and DIC score in rTM group was slightly higher than in non-rTM group (p = 0.08). In non-rTM group, significant improvement showed in WBC, Plt and CRP. On the other hand, in rTM group, CRP and FDP became significantly improved after treatment. Improvement of DIC score from baseline to day 4-7 were much significantly greater in the rTM group than in the non-rTM group (p < 0.01). In addition, definite adverse effects were not present in the rTM group. In conclusion, administration of rTM can be used safely and may have same or more beneficial effect in patients with DIC induced by UTI, compared with conventional treatment (Rinsho Hinyokika 71 : 79-83, 2017).