| 孙静怡,李文强.脓毒症患者血管麻痹机制研究进展[J].济宁医学院学报,2024,47(3):242-244 |
| 脓毒症患者血管麻痹机制研究进展 |
| Progress in the mechanism of vasomplegia in patients with septic shock |
| 投稿时间：2023-03-05 |
| DOI：10.3969/j.issn.1000-9760.2024.03.017 |
| 中文关键词: 脓毒症;血管麻痹;机制 |
| 英文关键词: Sepsis;Vasoplegia;Mechanism |
| 基金项目:山东省医药卫生科技发展计划项目(202117010481) |
| 作者 | 单位 | E-mail | | 孙静怡 | 济宁医学院临床医学院, 济宁 272013 | | | 李文强 | 济宁市第一人民医院重症医学科, 济宁 272011 | medicoli@126.com |
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| 全文下载次数: 34 |
| 中文摘要: |
| 脓毒症是人体对感染反应失调导致的器官功能障碍综合征,严重时表现为血管麻痹性休克,是导致患者死亡的重要原因。血管麻痹是一种病理性的低全身血管阻力综合征,主要特点是低血压和血管对收缩药物的低反应性。造成血管麻痹的原因有很多,临床上最常见的是脓毒症,其次是心脏手术,烧伤、创伤,某些药物等也会导致血管麻痹。血管麻痹缺乏统一的临床定义,其病理生理学复杂,涉及内皮源性舒张因子的释放、ATP敏感钾通道的过度激活、前列环素和血栓素A2平衡的破坏、氧自由基的过度产生等,对这些机制的理解为脓毒症血管麻痹的治疗提供了更多的选择。目前,去甲肾上腺素作为脓毒症患者容量复苏后血管麻痹治疗的首选药物,可能会产生一些副作用,像血管加压素等二线药物的出现预示着血管麻痹的治疗将有更大的潜力。 |
| 英文摘要: |
| Vasoplegia is the syndrome of pathological low systemic vascular resistance,characterized mainly by hypotension and low responsiveness to vasopressors.There are many causes of vasoplegia,and the most common is sepsis,followed by cardiac surgery,vasoplegia after surgery is called vasoplegic syndrome.Non-cardiac surgery,burns,trauma,pancreatitis,some drugs can also lead to vasoplegia.Vasoplegia lacks a uniform clinical definition and has a complex pathophysiology involving the release of endothelial-derived relaxing factors,overactivation of ATP-sensitive potassium channels,disruption of balance between prostacycline and thromboxane A2,overproduction of oxygen free radicals and so on.The understanding of these mechanisms provides additional options for the treatment of vasoplegia.Currently,norepinephrine,the first choice for the treatment of vasoplegia after volume resuscitation,may produce some side effects,and the emergence of second-line drugs like vasopressin portends greater potential for the treatment of vasoplegia. |
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