Department of Emergency Medicine, University of Washington School of Medicine, Seattle, Washington.
Semin Thromb Hemost. 2020 Mar;46(2):125-133. doi: 10.1055/s-0039-1701017. Epub 2020 Mar 11.
Trauma induces a change in nearly every observable aspect of hemostasis, generally tipping the balance toward trauma-induced coagulopathy (TIC) and bleeding in the critical early stages. Two particularly important aspects of TIC are platelets and fibrinogen, which are the primary determinants of clot formation and hemostasis. Their loss and dysfunction represent important transition points between coagulopathy phenotypes, highlighting their mechanistic roles in TIC as well as unveiling new potential avenues toward important diagnostic and therapeutic interventions. This review synthesizes current knowledge of platelets and fibrinogen during TIC, with a focus on emerging concepts related to their dysfunction and development of new therapeutic approaches.
创伤几乎会引起止血过程中所有可观察到的方面的变化,通常会导致创伤诱导的凝血病(TIC)和在关键的早期阶段出血。TIC 的两个特别重要的方面是血小板和纤维蛋白原,它们是血栓形成和止血的主要决定因素。它们的丧失和功能障碍代表了凝血病表型之间的重要过渡点,突出了它们在 TIC 中的机制作用,并为重要的诊断和治疗干预措施开辟了新的潜在途径。这篇综述综合了目前关于 TIC 期间血小板和纤维蛋白原的知识,重点介绍了与其功能障碍相关的新概念以及新治疗方法的发展。