Département Universitaire de Réanimation, Université de Lille 2, Service de Réanimation polyvalente, Hôpital Roger Salengro, CHRU de Lille, France.
Crit Care Med. 2012 Sep;40(9):2704-8. doi: 10.1097/CCM.0b013e318258ff30.
It was suggested more than 30 yrs ago that inhibition of the clotting cascade by natural anticoagulants could decrease the high mortality observed in patients suffering from severe sepsis and septic shock. Unfortunately, this therapeutic "paradigm" has led to a dead end, illustrated by the failure of all randomized trials and the recent withdrawal of recombinant activated protein C. Should we now definitely give up trying to treat septic coagulation disturbances or is there any therapeutic alternative?
早在 30 多年前就有人提出，通过天然抗凝剂抑制凝血级联反应，可以降低严重脓毒症和感染性休克患者的高死亡率。不幸的是，这种治疗“范式”已经走入死胡同，所有随机试验的失败和重组激活蛋白 C 的最近撤市都证明了这一点。我们现在是否应该断然放弃治疗脓毒症凝血紊乱的尝试，还是有其他治疗选择？
