标题：急性创伤性凝血病发病机制的研究进展

      作者：黄剑吟，封启明
    (上海交通大学附属第六人民医院急诊医学科，上海 200233)

      卷次： 2015年26卷21期

      【摘要】 急性创伤性凝血病是严重创伤患者常见的合并症，是一个多因素共同作用的结果，预后较差，其主
要发病机制尚未完全明确。既往对于其发病机制的认识主要是凝血因子的消耗或稀释、低体温或酸中毒，虽然
至今这种“致命三联症”仍是急性创伤性凝血病病理生理的重要因素，但是更深入地研究发现了更为复杂和多元
化的机制。目前发现的机制主要有内皮功能障碍、活化蛋白C、纤溶亢进、血小板功能障碍、氧化修饰作用等。我
们仍需更深入地研究急性创伤性凝血病发病机制，以进一步地改进复苏策略、提高创伤患者的生存率及改善创
伤患者预后。

      【关键词】 创伤；凝血病；发病机制；活化蛋白C；活性氧

      【中图分类号】 R554 【文献标识码】 A 【文章编号】 1003—6350（2015）21—3190—05


Research progress on the pathogenesis of acute traumatic coagulopathy.
HUANG Jian-yin, FENG Qi-ming.
Department of Emergency, the Sixth People's Hospital, Shanghai Jiaotong University, Shanghai 200233, CHINA
【Abstract】 Acute traumatic coagulopathy is a common complication in patients with severe trauma. It is the
result of an interaction of multiple factors, with poor prognosis. The main pathogenesis is not yet fully clear. Previous
understanding of its pathogenesis is mainly focus on the consumption or dilution of coagulation factors, hypothermia
or metabolic acidosis. Although so far this "deadly triad" is still the important factor of the pathophysiology of acute
traumatic coagulopathy, recent studies revealed more complex and diverse mechanisms, including endothelial dysfunc-
tion, activated protein C, fibrinolysis, platelet dysfunction, and oxidative modification. More in-depth studies focusing
on the pathogenesis of acute traumatic coagulopathy are still needed in order to further improve the recovery strate-
gies, the survival rate of patients with trauma, and the prognosis.

      【Key words】 Trauma; Coagulopathy; Pathogenesis; Activated protein C; Reactive oxygen