失血性休克致血管内皮糖萼损伤的机制及防治措施研究进展

Hemorrhagic shock‑induced vascular endothelial glycocalyx damage:progress on mechanism of damage and preventive and therapeutic strategies

失血性休克是由于快速大量失血导致危及生命的器官灌注不足,是平战时创伤性死亡的主要原因。血管内皮糖萼(vEG)对维持微循环稳态发挥重要作用。失血性休克严重缺血缺氧可导致vEG损伤、内皮细胞功能受损,进而加重微循环和脏器功能障碍。因此,早期防治失血性休克致vEG损伤可改善微循环功能障碍,对失血性休克的治疗及预后极为重要。目前防治失血性休克致vEG损伤研究繁多,但临床尚无基于防治vEG损伤的失血性休克救治方法。笔者就失血性休克致vEG损伤机制及防治措施的研究进展进行综述,为进一步对防治失血性休克致vEG损伤的基础研究及临床应用提供参考。

Hemorrhagic shock,a life⁃threatening organ hypoperfusion caused by rapid,massive blood loss,is the leading cause of traumatic death in peacetime and wartime.The vascular endothelial glycocalyx(vEG)plays an important role in maintaining microcirculatory homeostasis.Severe ischemia and hypoxia of hemorrhagic shock can damage the vEG,leading to endothelial dysfunction and exacerbated microcirculatory and organ impairments.Therefore,early prevention and treatment of vEG damage in hemorrhagic shock can improve microcirculation dysfunction,which is of paramount importance for therapeutic efficacies and outcomes.There have been many studies on the prevention and treatment of vEG damage in hemorrhagic shock,but none is based on the management of vEG damage.The authors reviewed the progress on the mechanism and preventive and therapeutic strategies of vEG damage caused by hemorrhagic shock,hoping to provide reference for the further research of hemorrhagic shock⁃induced vEG damage.