基于SIC评分的脓毒症性凝血病患者普通肝素抗凝治疗的研究进展

李 玉翠1, 黄 德宽1, 李 军2
1、右江民族医学院研究生学院
2、右江民族医学院附属医院重症医学科

摘要


脓毒症（sepsis）是严重感染所导致宿主免疫反应失衡所致的危机生命的多器官功能障碍综合征[1]。其中，60％左右的患者会出现凝血功能障碍，并且加重脏器功能衰竭进而增加患者的临床死亡率[2]。脓毒症性凝血病（sepsis-induced coagulopathy，SIC）是指感染状态下诱发的以凝血功能紊乱为特征的脓毒症[3]。据报道，全球范围内每年约有5000万脓毒症患者，其中SIC在脓毒症患者中发生率为25％左右，与脓毒症相关的死亡患者高达1100万，大约占全球死亡人数的1/5，而SIC的死亡率占比约1/4至1/2[2，4，5]。但是，目前针对SIC的脓毒症患者是否需抗凝治疗仍受争议。有部分研究证明对脓毒症患者进行抗凝治疗有助于减少患者脏器功能损伤程度进而改善患者器官功能[6]，而肝素是常见抗凝药物。本文拟对目前基于SIC评分对脓毒症性凝血病患者使用普通肝素（Unfractionated Heparin，UFH）抗凝的可行性研究进展做一评述。

关键词


脓毒症；SIC评分；抗凝治疗；普通肝素；凝血功能障碍

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参考


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