COVID-19 凝血功能障碍的独特特征。

Department of Emergency and Disaster Medicine, Juntendo University Graduate School of Medicine, 2-1-1 Hongo Bunkyo-ku, Tokyo, 113-8421, Japan.

Department of Anesthesiology, Critical Care, and Surgery, Duke University School of Medicine, Durham, NC, USA.

Crit Care. 2020 Jun 18;24(1):360. doi: 10.1186/s13054-020-03077-0.

Thrombotic complications and coagulopathy frequently occur in COVID-19. However, the characteristics of COVID-19-associated coagulopathy (CAC) are distinct from those seen with bacterial sepsis-induced coagulopathy (SIC) and disseminated intravascular coagulation (DIC), with CAC usually showing increased D-dimer and fibrinogen levels but initially minimal abnormalities in prothrombin time and platelet count. Venous thromboembolism and arterial thrombosis are more frequent in CAC compared to SIC/DIC. Clinical and laboratory features of CAC overlap somewhat with a hemophagocytic syndrome, antiphospholipid syndrome, and thrombotic microangiopathy. We summarize the key characteristics of representative coagulopathies, discussing similarities and differences so as to define the unique character of CAC.

COVID-19 常伴有血栓并发症和凝血功能障碍。然而，COVID-19 相关凝血功能障碍（CAC）的特征与细菌脓毒症引起的凝血功能障碍（SIC）和弥散性血管内凝血（DIC）不同，CAC 通常表现为 D-二聚体和纤维蛋白原水平升高，但最初凝血酶原时间和血小板计数基本正常。与 SIC/DIC 相比，CAC 中静脉血栓栓塞和动脉血栓形成更为常见。CAC 的临床和实验室特征与噬血细胞综合征、抗磷脂综合征和血栓性微血管病有些重叠。我们总结了有代表性的凝血障碍的关键特征，讨论了它们的异同，以明确 CAC 的独特特征。