| Project/Area Number |
17K17054
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| Research Category |
Grant-in-Aid for Young Scientists (B)
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| Allocation Type | Multi-year Fund |
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| Research Field |
Emergency medicine
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| Research Institution | Ehime University |
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Principal Investigator |
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| Project Period (FY) |
2017-04-01 – 2019-03-31
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| Project Status |
Completed (Fiscal Year 2018)
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| Budget Amount *help |
¥4,160,000 (Direct Cost: ¥3,200,000、Indirect Cost: ¥960,000)
Fiscal Year 2018: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
Fiscal Year 2017: ¥2,080,000 (Direct Cost: ¥1,600,000、Indirect Cost: ¥480,000)
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| Keywords | 凝固線溶動態 / 血管内皮細胞障害 / 播種性血管内凝固症候群 / 外傷 / 敗血症 / 心停止後症候群 / 熱中症 / 外科周術期 / 凝固線溶異常 / DIC / 臨床研究 |
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| Outline of Final Research Achievements |
Our aim of this study was to clarify coagulofibrinolytic responses in critical situations and apply obtained dynamics into treatment strategies. In this study, we assessed coagulofibrinolytic markers including indices of inflammation and endothelial cell injury from acute critical patients admitted to our university hospital. The results of the coagulofibrinolytic responses showed a stress-induced coagulatory activation and a fibrinolytic change from an activated to suppressed state depending on a balance between t-PA and PAI-1 similarly in many critical situations. In certain situations, we demonstrated DIC treatment strategy based on the coagulofibrinolytic changes was very effective. Furthermore, our results represented that coagulofibrinolytic disorders might be associated with endothelial cell injury. These clarifications of coagulofibrinolytic responses and mechanisms should be essential for the construction of treatments for coagulofibrinolytic disorders in critical conditions.
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| Academic Significance and Societal Importance of the Research Achievements |
急性病態における凝固線溶異常は治療介入すべき問題点である。しかし、DIC治療で見られるように、大規模RCTの結果では肯定されない。その原因の一つは治療開始基準にあると考えられる。今回の結果、急性病態における凝固線溶動態をマーカーを用いて適確に捉えることができ、治療開始基準へと応用が可能であると考えられた。今後、DIC治療が必要かつ奏効する治療開始基準をマーカーとその動態考慮して設定していくことで、真の治療効果が明らかにされるものと思われる。
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