[關鍵詞]
[摘要]
膿毒癥作為一種由感染導致的一系列病理生理異常和自身組織損傷而出現的一種威脅生命的狀況,是重癥監(jiān)護病房(ICU)的常見疾病之一。在膿毒癥病程發(fā)展過程中,病原相關分子模式(PAMP)、炎性介質、中性粒細胞胞外誘捕網(NET)等多種因素在誘導炎癥反應的同時,激活患者機體的凝血功能。凝血系統的過度激活可能對宿主機體造成傷害,致膿毒癥相關性凝血病和彌散性血管內凝血(DIC)的發(fā)生,進而發(fā)展為危及生命的多器官功能障礙(MODS),大大增加了患者的死亡風險。如何及時糾正膿毒癥相關性凝血病與凝血功能障礙,有效改善患者預后,也成為了膿毒癥治療領域的研究熱點之一。主要對重組人活化蛋白C(rhAPC)、重組人可溶性血栓調節(jié)蛋白(rhsTM)、抗凝血酶III(AT III)、重組組織因子途徑抑制劑(rTFPI)、肝素和血必凈注射液等膿毒癥相關性凝血病治療藥物的研究進展進行綜述。
[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.
[中圖分類號]
R973
[基金項目]
天津市科委重點研發(fā)計劃院市合作項目(18YFYSZC00210)