CAJ | 학술논문

从单一血小板计数的下降到DIC,凝血系统异常在危重病患者中屡见不鲜,病死率随之升高.在脓毒症中,组织因子活化外源性凝血途径增强凝血,同时诱导抗凝和阻碍纤维蛋白溶解,从而造成机体高凝血状态,形成微血管血栓,干扰器官微循环,导致器官功能衰竭.许多炎症介质涉及到凝血系统的活化;反之,许多凝血蛋白与炎症也密切相关.此文综述了炎症和凝血的复杂关系,对这一关系的全新理解有助于形成新的治疗脓毒症的措施.
종단일혈소판계수적하강도DIC,응혈계통이상재위중병환자중루견불선,병사솔수지승고.재농독증중,조직인자활화외원성응혈도경증강응혈,동시유도항응화조애섬유단백용해,종이조성궤체고응혈상태,형성미혈관혈전,간우기관미순배,도치기관공능쇠갈.허다염증개질섭급도응혈계통적활화;반지,허다응혈단백여염증야밀절상관.차문종술료염증화응혈적복잡관계,대저일관계적전신리해유조우형성신적치료농독증적조시.
Coagulation abnormalities,ranging from a simple fall in platelet count to full-blown disseminated intravascular coagulation,are common occurrences in severe diseases patients and have been associated with increased mortality.In.sepsis,activation of the extrinsic coagulation pathway by tissue factor induces increased coagulation,simultaneous depression of the inhibitory mechanisms of coagulation,and suppression of the fibrinolytic system results in a procoagulant state that may lead to the formation of microvascular thrombi disturbing organ microcirculation and promoting the development of organ dysfunction.Many inflammatory mediators are involved in the activation of coagulation,but many coagulation proteins are themselves actively involved in the inflammatory process.In this article,we explore the complex relation between inflammation and coagulation and how improved understanding of this interaction has led to the development of new therapeutic agents for patients with severe sepsis.