膿毒癥作為一種由感染導(dǎo)致的一系列病理生理異常和自身組織損傷而出現(xiàn)的一種威脅生命的狀況，是重癥監(jiān)護(hù)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(guān)分子模式（PAMP）、炎性介質(zhì)、中性粒細(xì)胞胞外誘捕網(wǎng)（NET）等多種因素在誘導(dǎo)炎癥反應(yīng)的同時(shí)，激活患者機(jī)體的凝血功能。凝血系統(tǒng)的過度激活可能對(duì)宿主機(jī)體造成傷害，致膿毒癥相關(guān)性凝血病和彌散性血管內(nèi)凝血（DIC）的發(fā)生，進(jìn)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(fēng)險(xiǎn)。如何及時(shí)糾正膿毒癥相關(guān)性凝血病與凝血功能障礙，有效改善患者預(yù)后，也成為了膿毒癥治療領(lǐng)域的研究熱點(diǎn)之一。主要對(duì)重組人活化蛋白C（rhAPC）、重組人可溶性血栓調(diào)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(guān)性凝血病治療藥物的研究進(jìn)展進(jìn)行綜述。

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.

R973

天津市科委重點(diǎn)研發(fā)計(jì)劃院市合作項(xiàng)目（18YFYSZC00210）