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  • 王 暄,任慧娟,唐伦先.脓毒症相关凝血功能障碍的发病机制及诊断进展[J].同济大学学报(医学版),2020,41(4):523-529.    [点击复制]
  • WANG Xuan,REN Hui-juan,TANG Lun-xian.Advance in pathogenesis and diagnostic criteria in sepsis-induced coagulopathy and disseminated intravascular coagulation[J].同济大学学报(医学版),2020,41(4):523-529.   [点击复制]
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脓毒症相关凝血功能障碍的发病机制及诊断进展
王暄,任慧娟,唐伦先
0
(南京医科大学上海东方临床医学院,南京 210029; 同济大学附属东方医院急诊内科,上海 200120;上海市东方医院吉安医院急诊内科,江西 吉安 343000)
摘要:
脓毒症相关凝血功能障碍主要包括脓毒症继发弥散性血管内凝血和继发凝血病两种形式。脓毒症凝血功能障碍发病机制复杂,目前尚未完全阐明,主要涉及促凝、抗凝、纤溶系统和内皮功能障碍等方面,临床医师很难早期识别。目前临床上广泛采用的诊断标准主要有4个,研究发现其在脓毒症性凝血功能障碍的早期诊断方面日益显示出不足。近年来研究发现,新的凝血监测方法在早期诊断方面显示出一定优势,本文就脓毒症性凝血功能障碍的发病机制、诊断和监测进展进行综述。
关键词:  脓毒症  弥漫性血管内凝血  血栓调节蛋白  凝血酶抗凝血酶复合物  纤溶酶抗纤溶酶复合物  组织型纤溶酶原激活抑制复合物
DOI:10.16118/j.1008-0392.2020.04.022
投稿时间:2020-01-21
基金项目:上海市重中之重重点专科项目(2017ZZ02017);上海市浦东新区卫生和计划生育委员会临床高峰学科项目(PWYgf2018-05);上海市浦东新区卫生和计划生育委员会领先人才项目(PWRI2019-05);江西省自然科学基金重点项目(S2018ZRZDB0179);国家自然科学基金面上项目(81970072)
Advance in pathogenesis and diagnostic criteria in sepsis-induced coagulopathy and disseminated intravascular coagulation
WANG Xuan,REN Hui-juan,TANG Lun-xian
(Shanghai East Hospital Clinical Medical College,Nanjing Medical University, Nanjing 210029, China; Dept. of Internal Emergency, East Hospital, Tongji University School of Medicine, Shanghai 200120,China; Dept. of Internal Emergency, Ji'an Hospital, Shanghai East Hospital, Ji'an 343000, Jiangxi Province, China)
Abstract:
Sepsis-induced coagulopathy and disseminated intravascular coagulation(DIC) are the two kinds of coagulation disorders. The molecular mechanism of sepsis-induced coagulation disorders is complex and remains to be illustrated. Multiple factors activate coagulation during sepsis including activation of coagulation cascade, impairment of anticoagulant system, inhibition of fibrinolytic system and endothelial dysfunction. Although several criteria have been proposed for diagnosing overt DIC, these criteria are not suitable for early detection. Recently, new testing methods have been identified to be superior to conventional ones. In this article, we will review recent the current advances in the pathogenesis and diagnostic methods of sepsis-induced coagulation disorders.
Key words:  sepsis  disseminated intravascular coagulation  thrombomodulin  thrombin-antithrombin complex  plasminogen antifibrinolytic complex  tissue plasminogen activator inhibitor complex

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