中性粒细胞胞外诱捕网在脓毒症相关性凝血功能障碍中的作用研究进展

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

脓毒症是机体对感染的反应失调导致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。凝血功能障碍贯穿于脓毒症的病理生理过程,其严重程度与脓毒症预后密切相关。中性粒细胞胞外诱捕网(NETs)是一种以DNA为骨架、镶有多种蛋白质组分的三维网状结构,其过度产生可激活凝血系统,抑制抗凝系统,抵抗纤维蛋白溶解作用,损伤血管内皮细胞,并通过与血小板的相互作用导致脓毒症相关性凝血功能障碍(SIC)发生。目前,有关SIC的治疗主要为对症治疗,尚无公认有效的抗凝策略。针对NETs及其组分的干预和抗血小板药物有望成为疾病治疗新的研究方向。

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.