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[中性粒细胞胞外陷阱在脓毒症诱导的凝血病中作用的研究进展]

[The research progress on the role of NETs in sepsis-induced coagulopathy].

作者信息

Chen Yuwei, Chen Weiwei, Chen Ying, Chen Erzhen

机构信息

Department of Emergency, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China. Corresponding author: Chen Erzhen, Email:

出版信息

Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2022 Feb;34(2):198-201. doi: 10.3760/cma.j.cn121430-20210221-00264.

Abstract

Sepsis is defined as a life-threatening organ dysfunction caused by the dysregulated host response to infection, and is one of the main causes of death in intensive care unit (ICU) patients. Coagulation dysfunction runs through the pathophysiological progress of sepsis whose severity should be closely related to the prognosis of sepsis. Neutrophil extracellular traps (NETs) is a three-dimensional network structure with DNA as the skeleton and inlaid with various protein components. The excessive production of NETs can lead to sepsis-induced coagulopathy (SIC) by activating the coagulation system, inhibiting the anticoagulation system, resisting fibrinolysis, damaging vascular endothelial cells and the interaction of platelets. At present, the treatment of SIC is mainly symptomatic treatment, and there is no recognized effective anticoagulation strategy. Interventions for NETs and their components, and drugs for antiplatelets are expected to become new directions for disease treatment.

摘要

脓毒症被定义为由宿主对感染的失调反应引起的危及生命的器官功能障碍,是重症监护病房(ICU)患者的主要死亡原因之一。凝血功能障碍贯穿脓毒症的病理生理过程,其严重程度应与脓毒症的预后密切相关。中性粒细胞胞外陷阱(NETs)是一种以DNA为骨架并镶嵌有各种蛋白质成分的三维网络结构。NETs的过度产生可通过激活凝血系统、抑制抗凝系统、抵抗纤维蛋白溶解、损伤血管内皮细胞以及血小板的相互作用导致脓毒症诱导的凝血病(SIC)。目前,SIC的治疗主要是对症治疗,尚无公认有效的抗凝策略。针对NETs及其成分的干预措施以及抗血小板药物有望成为疾病治疗的新方向。

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