The Combination of the Lactate Dehydrogenase/Hemoglobin Ratio with the PLASMIC Score Facilitates Differentiation of TTP from Septic DIC Without Identification of Schistocytes

• 資料種別: 博士論文
• タイトル: The Combination of the Lactate Dehydrogenase/Hemoglobin Ratio with the PLASMIC Score Facilitates Differentiation of TTP from Septic DIC Without Identification of Schistocytes
• 著者・編者: Nishimura, Nobushiro; Yoshimoto, Kiyomi; Yada, Noritaka; Kakiwaki, Ayaka; Sawa, Akihiro; Senzaki, Satoshi; Kawashima, Hiromasa; Yoneima, Ryo; Ono, Shiro; Sakai, Kazuya; Matsumoto, Masanori; Fukushima, Hidetada; Nishio, Kenji
• 著者標目: Nishimura, Nobushiro; Yoshimoto, Kiyomi; Yada, Noritaka; Kakiwaki, Ayaka; Sawa, Akihiro; Senzaki, Satoshi; Kawashima, Hiromasa; Yoneima, Ryo; Ono, Shiro; Sakai, Kazuya; Matsumoto, Masanori; Fukushima, Hidetada; Nishio, Kenji
• 出版事項: SAGE Publications
• 出版年月日等: 2023-10; 29
• 出版年（W3CDTF）: 2023-10
• 並列タイトル等: LD/Hb比をPLASMICスコアと一緒に使用することで、破砕赤血球の識別なしにTTPと敗血症性DICの区別が容易になる
• 授与機関名: 奈良県立医科大学
• 授与年月日: 2024-06-26
• 授与年月日（W3CDTF）: 2024-06-26
• 報告番号: 甲第933号
• 学位: 博士（医学）
• 本文の言語コード: eng
• 件名標目: LD/Hb ratio; PLASMIC score; TTP; sepsis‌; septic DIC
• 対象利用者: 一般
• 一般注記: type:Thesis; In some cases, differentiating thrombotic thrombocytopenic purpura (TTP) from septic disseminated intravascular coagulation (DIC) without measuring ADAMTS13 activity is critical for urgent lifesaving plasma exchange. To investigate whether PLASMIC score without identifying the presence of schistocytes, D-dimer, fibrin/fibrinogen degradation products (FDP), FDP/D-dimer ratio, prothrombin time-international normalized ratio (PT-INR), lactate dehydrogenase (LD), hemoglobin (Hb), and LD/Hb ratio are useful in differentiating patients with TTP from those with septic DIC. Retrospective analysis was conducted on the medical records of the patients with septic DIC (32 patients) or TTP (16 patients). The PLASMIC score and other laboratory measurements all were helpful in differentiating TTP from septic DIC. When dichotomized between high risk (scores 6-7) and intermediate-low risk (scores 0-5), the PLASMIC score predicted TTP with a sensitivity of 75.0% and a specificity of 100%. However, 4 of 16 patients with TTP and 19 of 32 patients with septic DIC showed comparable PLASMIC scores of 4 or 5, making it difficult to distinguish between the two by PLASMIC score alone. Among the measurements examined, the LDH/Hb ratio was the most useful for differentiation. Receiver operating characteristic analysis of the LD/Hb ratio for predicting TTP revealed a cutoff of 53.7 (IU/10 g) (sensitivity 0.94, specificity 0.91). If the LD/Hb ratio was less than 53.7, it was unlikely that the patient had TTP. A combination of the LD/Hb ratio and the PLASMIC score may be useful for distinguishing between TTP and DIC and identifying patients who need rapid plasma exchange or caplacizumab administration.; 権利情報：Nishimura N, et al. The Combination of the Lactate Dehydrogenase/Hemoglobin Ratio with the PLASMIC Score Facilitates Differentiation of TTP from Septic DIC Without Identification of Schistocytes. Clinical and Applied Thrombosis-Hemostasis. 2023. 29:10760296231207629. Copyright © The Author(s) 2023. doi: 10.1177/10760296231207629; identifier:Clinical and applied thrombosis/hemostasis. 2023 Oct, vol.29, article no.10760296231207600; identifier:1076-0296; identifier:http://ginmu.naramed-u.ac.jp/dspace/handle/10564/4390; identifier:Clinical and applied thrombosis/hemostasis, 29: 10760296231207600
• 国立国会図書館永続的識別子: info:ndljp/pid/13730983; https://dl.ndl.go.jp/pid/13730983
• コレクション（共通）: 障害者向け資料
• コレクション（障害者向け資料：レベル1）: テキストデータ
• コレクション（個別）: 国立国会図書館デジタルコレクション > デジタル化資料 > 博士論文; https://dl.ndl.go.jp/collections/A00014
• 収集根拠: 博士論文（自動収集）
• 受理日（W3CDTF）: 2024-08-02T22:09:18+09:00
• 記録形式（IMT）: application/pdf
• オンライン閲覧公開範囲: 国立国会図書館内限定公開
• デジタル化資料送信: 図書館・個人送信対象外
• 遠隔複写可否（NDL）: 可
• 掲載誌（URI）: http://hdl.handle.net/10564/4390
• 連携機関・データベース: 国立国会図書館 : 国立国会図書館デジタルコレクション; https://dl.ndl.go.jp