造血干细胞移植相关毛细血管渗漏综合征的研究进展

Research Progress on Capillary Leak Syndrome Associated with Hematopoietic Stem Cell Transplantation--Review

毛细血管渗漏综合征是一组以血管内皮屏障功能破坏、血管通透性增加、可逆性全身水肿为特征的临床综合征,是造血干细胞移植后早期致命性并发症之一。迄今为止,毛细血管渗漏综合征的确切发病机制尚未被阐明,诊断标准与治疗方法尚不统一。目前认为,毛细血管渗漏综合征的根本原因在于高细胞因子血症,核心为血管内皮细胞高通透性。根据临床表现,其自然病程可分为前驱期、渗漏期和恢复期。在治疗方面,根据各期不同特点以对症支持治疗为主。本文就造血干细胞移植相关毛细血管渗漏综合征的发病机制、临床表现、诊断与治疗等方面进行简要综述。

Capillary leak syndrome(CLS)is a clinical syndrome characterized by impairment of vascular endothelial barrier function,increased vascular permeability,and reversible systemic edema.It is one of the early fatal complications after hematopoietic stem cell transplantation.So far,the exact pathogenesis of CLS has not been elucidated,and the diagnostic criteria and treatment methods have not been unified.At present,it is believed that the fundamental cause of CLS is hypercytokinemia,and the core factor is high permeability of vascular endothelial cells.According to the clinical manifestations,the natural course of CLS can be divided into prodrome,leakage and recovery stages.As far as treatment is concerned,symptomatic and supportive treatment is dominant according to different characteristics of each stage.In this review,the pathogenesis,clinical manifestations,diagnosis and treatment of hematopoietic stem cell transplantassociated CLS were briefly summarized.