[关键词]
[摘要]
脓毒症作为一种由感染导致的一系列病理生理异常和自身组织损伤而出现的一种威胁生命的状况,是重症监护病房(ICU)的常见疾病之一。在脓毒症病程发展过程中,病原相关分子模式(PAMP)、炎性介质、中性粒细胞胞外诱捕网(NET)等多种因素在诱导炎症反应的同时,激活患者机体的凝血功能。凝血系统的过度激活可能对宿主机体造成伤害,致脓毒症相关性凝血病和弥散性血管内凝血(DIC)的发生,进而发展为危及生命的多器官功能障碍(MODS),大大增加了患者的死亡风险。如何及时纠正脓毒症相关性凝血病与凝血功能障碍,有效改善患者预后,也成为了脓毒症治疗领域的研究热点之一。主要对重组人活化蛋白C(rhAPC)、重组人可溶性血栓调节蛋白(rhsTM)、抗凝血酶III(AT III)、重组组织因子途径抑制剂(rTFPI)、肝素和血必净注射液等脓毒症相关性凝血病治疗药物的研究进展进行综述。
[Key word]
[Abstract]
Sepsis, one of the common diseases in intensive care unit (ICU), is a life-threatening condition caused by a series of pathophysiological abnormalities and tissue damage caused by infection. In the course of sepsis, a variety of factors such as pathogen-associated molecular pattern (PAMP), inflammatory mediators, neutrophils extracellular trapping (NET) activate the coagulation function of patients while inducing the inflammatory response. Over activation of the coagulation system may be detrimental to the host body, leading to the occurrence of sepsis-associated coagulation and disseminated intravascular coagulation (DIC), which develops into life-threatening multi-organ dysfunction (MODS) further, significantly increasing the risk of death in the patient. How to timely correct sepsis-associated coagulation and coagulation dysfunction, and effectively improve the prognosis of patients, has become one of the research hotspots in the field of sepsis treatment. Treatment drugs of sepsis-associated coagulation such as rhAPC, rhsTM, AT III, rTFPI, heparin, and Xuebijing Injection and so on are reviewed in this paper.
[中图分类号]
R973
[基金项目]
天津市科委重点研发计划院市合作项目(18YFYSZC00210)