在COVID-19凝血病中接触途径的参与
Marco Capecchi1,2, Cristina Novembrino3, Maria Abbattista3
1Angelo Bianchi Bonomi Hemophilia and Thrombosis Center, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy. m.capecchi87@gmail.com.
Internal and emergency medicine
|November 8, 2025
概括
COVID-19患者表现出独特的凝血病,内在途径 (FXIa,FXIIa) 和接触激活的标志物增加,与疾病严重程度相关. 这表明有针对性的抗凝固药疗法可能有利于患有严重COVID-19的患者.
科学领域:
- 血液学 血液学 血液学
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
背景情况:
- COVID-19与一种新的获得性凝血病有关.
- 严重的血凝剂失衡与COVID-19患者的临床严重程度相关.
研究的目的:
- 阐明COVID-19患者凝血激活的机制.
- 调查凝血标志物与疾病严重程度之间的关系.
主要方法:
- 111名COVID-19症状患者被分为低强度,中等强度和高强度护理组.
- 测量了内在 (FXIa,FXIIa) 和外在 (FVIIa) 途径激活的标记物,纤维解质,D-二次体,纤维素单体,纤维素降解产物和C1抑制剂.
- 记录了静脉血栓发生率.
主要成果:
- 在COVID-19患者中,D-二聚合物,纤维素单聚合物和纤维素降解产物水平升高.
- 较低的FVIIa水平与较高的FXIIa和FXIa水平形成对比,表明接触通路的激活.
- 随着护理强度的增加,FXIIa水平增加,所有组中C1抑制剂都升高.
- 29%的患者发生了静脉血栓形成.
结论:
- COVID-19的特点是普遍接触途径激活,而不是外部途径.
- 凝血激活与COVID-19的临床严重程度成比例.
- 这些发现表明,在COVID-19患者中,有针对性的抗凝固药疗法的潜力.
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