与损伤相关的分子模式作为危重病患者透析器膜上的血栓形成的媒介
Kaori Okamoto1, Takashi Ito2, Sara Sato3
1From the Division of Medical Engineering Center, Hokkaido University Hospital, Sapporo, Japan.
概括
炎症和损伤相关的分子模式 (DAMPs) 导致透器凝血,在临床重症患者接受脏替代疗法 (RRT). 升高的DAMP与扩散性血管内凝血 (DIC) 严重程度相关,突出了对血栓预防策略的需要.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 临界护理医学 临界护理医学
- 免疫学 免疫学 免疫学
背景情况:
- 透析器凝血是脏替代疗法 (RRT) 的重要并发症.
- 炎症和损伤相关的分子模式 (DAMPs) 涉及到血栓事件.
研究的目的:
- 为了研究炎症,DAMP和透析器膜血栓形成之间的关系,在接受RRT的重症患者中.
- 确定有助于透析器凝血的机制和潜在的干预措施.
主要方法:
- 前性研究比较炎症性 (CRP>10 mg/dl) 和非炎症性 (CRP <5 mg/dl) 严重病的RRT患者.
- 在透析器膜中量化无细胞DNA,HMGB1,基因素H3和MPO.
- 在膜表面对白细胞,纤维素和血小板血栓的免疫化.
主要成果:
- 与对照组相比,炎症患者显示细胞自由DNA,HMGB1和MPO的升高;基因素H3没有变化.
- 随着传播性血管内凝血 (DIC) 的严重程度,DAMP水平增加.
- 炎症组中的透析器膜表现出白细胞,中性细胞外细胞陷状结构,纤维素和血小板血栓.
结论:
- 在炎症RRT患者的透析器膜上增加的DAMP与炎症,凝血激活和凝血有关.
- 研究结果表明,DAMP在透析器血栓形成中起作用,特别是在DIC患者中.
- 对于DIC重症患者的RRT中对血栓预防的进一步研究是有必要的.
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