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新型冠状病毒 2 型与不同器官中的凝血功能障碍。

SARS-CoV-2 and coagulation disorders in different organs.

机构信息

Department of Biotechnology, Periyar University PG, Extension Centre, Dharmapuri, Tamil Nadu 636701, India.

Department of Biotechnology, Periyar University PG, Extension Centre, Dharmapuri, Tamil Nadu 636701, India.

出版信息

Life Sci. 2020 Nov 1;260:118431. doi: 10.1016/j.lfs.2020.118431. Epub 2020 Sep 15.

Abstract

Coronavirus disease 2019 (COVID-19) is a prominent pandemic disease that emerged in China and hurriedly stretched worldwide. There are many reports on COVID-19 associated with the amplified incidence of thrombotic events. In this review, we focused on COVID-19 coupled with the coagulopathy contributes to severe outcome inclusive of comorbidities such as venous thromboembolism, stroke, diabetes, lung, heart attack, AKI, and liver injury. Initially, the COVID-19 patient associated coagulation disorders show an elevated level of the D-dimer, fibrinogen, and less lymphocyte count such as lymphopenia. COVID-19 associated with the Kawasaki disease has acute vasculitis in childhood which further affects the vessels found all over the body. COVID-19 linked with the thrombotic microangiopathy triggers the multiple vasculitis along with the arterioles thrombosis, medium, large venous and arterial vessels mediates the disseminated intravascular coagulation (DIC). SARS-Co-V-2 patients have reduced primary platelet production, increased destruction of the platelet, decreased circulating platelet leads to the condition of increased thrombocytopenia which contributes to the coagulation disorder. Endothelial dysfunction plays an important role in the coagulation disorders via increased generation of the thrombin and stops fibrinolysis further leads to hypercoagulopathy. Along with that endothelial dysfunction activates the complement system pathways and contributes to the acute and chronic inflammation via cytokine storm with the production of the cytokines and chemokines, coagulation in different organs such as lung, brain, liver, heart, kidney and further leads to multi-organ failure.

摘要

2019 年冠状病毒病(COVID-19)是一种在中国出现并迅速蔓延全球的突出大流行病。有许多关于 COVID-19 与血栓事件发生率增加相关的报告。在这篇综述中,我们重点关注 COVID-19 合并凝血功能障碍导致严重后果,包括静脉血栓栓塞、中风、糖尿病、肺部、心脏病、急性肾损伤和肝损伤等合并症。最初,COVID-19 患者相关的凝血障碍表现为 D-二聚体、纤维蛋白原水平升高,淋巴细胞计数减少,如淋巴细胞减少症。COVID-19 与川崎病相关,川崎病在儿童时期发生急性血管炎,进一步影响全身血管。COVID-19 与血栓性微血管病相关,引发多发性小血管炎,伴有小动脉、中动脉、大静脉和动脉血栓形成,介导弥漫性血管内凝血(DIC)。SARS-CoV-2 患者血小板生成减少,血小板破坏增加,循环血小板减少导致血小板增多症,从而导致凝血障碍。内皮功能障碍通过增加凝血酶的生成和阻止纤维蛋白溶解在凝血障碍中起重要作用,进而导致高凝状态。此外,内皮功能障碍激活补体系统途径,通过细胞因子风暴产生细胞因子和趋化因子,导致肺部、大脑、肝脏、心脏、肾脏等不同器官的炎症,进而导致多器官衰竭。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/954b/7490584/f91153b3bd2e/ga1_lrg.jpg

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