Der Nachweis von löslichen Fibrinmonomer- Komplexen. Methodenvergleich eines Erythrozyten- Agglutinationstests nach Largo (FM-Test) mit dem Äthanol-Gelierungs-Test

Abstract

Hypercoagulability and disseminated intravascular coagulation (DIG) are characterized, by the presence of circulating fibrin monomer complexes in plasma. In 342 patients with possible DIC fibrin monomers, fibrinogen, repti/ase® time, antithrombin III and other coagulation parameters were determined at frequent intervals. Testing of soluble fibrin monomer complexes was performed using a sensitive and reliable haemagglutination assay with red cells sensitized by fibrin monomers (FM-Test) and the ethanol gelation test (EGT). Method comparison regarding the influence of fibrinogen levels and fibrin degradation products shows that high fibrinogen levels lead to false-positive results with EGT. The same effect is observed for fibrin degradation products and EGT whereas no influence of fibrinogen level and fibrin degradation products on the FM-Test occurs. It is wellknown that during DIC AT III level decreases caused by proteolytic activity.In this study it could be shown that fibrin monomer increases parallel to the decrease of AT III. The same effect does not occur due to fibrin degradation products.

Neue Methoden zur spezifischen Bestimmung von Fibrinspaltprodukten (D-Dimere)

“…So kann bei ablaufenden Aktivierungsprozessen die Thrombinwirkung durch die Parameter Fibrinopeptid A und lösliche Fibrinmonomer-Komplexe nachgewiesen werden, während die Fibrinogenbzw. Fibrinspaltprodukte die Plasminwirkung belegen und damit Ausdruck einer sekundären Fibrinolyse sind (8)(9)(10). Die diagnostische Aussage der Fibrin(ogen)-spaltproduktbestimmung konnte bislang wegen der fehlenden Differenzierungsmöglichkeit zwischen Fibrinogen-und Fibrinfragmenten nicht voll ausgeschöpft werden.…”