循环NET可以在紧急护理开始时早期识别败血症中的血栓风险
Sofia Tejada1, Antonio Clemente2,3, Antonia Socias1,4
1Multidisciplinary Sepsis Group, Health Research Institute of the Balearic Islands (IdISBa), Palma, Spain.
Frontiers in immunology
|November 13, 2025
概括
中性细胞细胞外陷 (NETs) 在败血症发病时与炎症和不良结果有关,而不是直接与早期凝血病有关. 然而,NET扩大了败血症诱导的凝血病 (SIC) 的影响,表明了联合免疫血栓风险.
科学领域:
- 免疫学 免疫学 免疫学
- 临界护理医学 临界护理医学
- 血液学 血液学 血液学
背景情况:
- 败血症是一种危及生命的疾病,其特点是宿主对感染的反应失调.
- 凝血病是败血症的常见并发症,增加器官功能障碍和死亡率.
- 在急诊室 (ED) 早期发现凝血障碍是具有挑战性的,中性粒细胞外陷 (NETs) 在早期败血症护理中的作用尚不清楚.
研究的目的:
- 评估在败血症发病时循环的NET和炎症生物标志物之间的关联.
- 为了确定NET是否与败血症诱导的凝血病 (SIC) 状态相关.
- 评估NETs对败血症患者临床结果的预后价值.
主要方法:
- 一项对212名向ED提交的成人败血症患者的回顾性研究.
- 血NET,IL-6和MR-ProADM都使用ELISA进行了测量.
- 国际血栓与血液静止学会 (ISTH) SIC评分被用来识别早期的凝血病.
主要成果:
- 在28.8%的患者中检测到循环NET,并与炎症标志物 (D-二分体,LDH,IL-6,PCT) 和低胆固醇血症的升高有关.
- NETs阳性与阳性血液培养,血栓栓塞事件和严重器官功能障碍 (SOFA ≥5) 的几率增加相关.
- 虽然没有独立地与SIC相关,但NET在SIC阳性患者中放大了炎症和临床影响,表明了协同相互作用.
结论:
- 在ED呈现时的NETs量化可能会在败血症中确定高风险的免疫血栓表型.
- NETs可以作为败血症不良结果的预后标志物.
- 早期针对NETosis的向疗法与抗凝药相结合可能对高风险败血症患者有益.
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