低分子肝素治疗病毒性肺炎致急性呼吸窘迫综合征的机制研究进展

Progress on the mechanisms of low molecular weight heparin in treating acute respiratory distress syndrome caused by viral pneumonia

急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS)是危重症病毒性肺炎患者重要的病理过程,而凝血功能紊乱则是病毒性肺炎患者的重要特征之一。近年来,越来越多的研究在探索病毒性肺炎导致ARDS的相关机制,虽然应用低分子肝素(low molecular weight heparin,LMWH)预防和治疗病毒性肺炎患者的血栓并发症已成为共识,但LMWH除具有抗凝作用外,亦具有抗炎、抗氧化等多重作用。因此LMWH对ARDS的治疗作用仍有待进一步全面探讨。该文旨在从病毒性肺炎的病理和临床特点等方面,探寻LMWH治疗ARDS的证据,对LMWH的治疗机制进行综述。

Acute respiratory distress syndrome(ARDS)is an important pathological process in patients with severe viral pneumonia.The coagulation disorder is one of the important characteristics of patients with viral pneumonia.In recent years,more and more studies have been exploring the related mechanisms of ARDS caused by viral pneumonia.Although the application of low molecular weight heparin(LMWH)to prevent and treat thrombotic complications in patients with viral pneumonia has become an industry consensus,in addition to anticoagulation,LMWH also has multiple effects such as anti-inflammatory and antioxidant.Therefore,the therapeutic effect of LMWH on ARDS remains to be fully explored.This article focuses on the pathological and clinical characteristics of viral pneumonia,to explore the evidence and clinical mechanisms of LMWH in the treatment of ARDS.