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脓毒症与血小板减少症:当今的一个问题。

Sepsis and Thrombocytopenia: A Nowadays Problem.

作者信息

Gonzalez Daniel A, Kumar Rajeswar, Asif Saba, Bali Anoushka, Dang Ashujot Kaur

机构信息

Medicine, Universidad Catolica Santiago de Guayaquil, Guayaquil, ECU.

Medicine, Rajah Muthaiah Medical College and Hospital, Chidambaram, IND.

出版信息

Cureus. 2022 May 27;14(5):e25421. doi: 10.7759/cureus.25421. eCollection 2022 May.

Abstract

Sepsis is a life-threatening organ failure produced by a dysregulated host response to infection that involves 15.6% of hospital mortality. The most common signs and symptoms of sepsis are hypotension, tachypnea, fever, and leukocytosis, whether suspected or confirmed. Including a major one, thrombocytopenia is a sign that is an independent predictor of poor outcomes in patients with sepsis, increasing their mortality rate and their length of stay in the intensive care unit (ICU). So far, the ongoing treatment for this problem is securing the airway, treating hypoxemia, and providing vascular access for hydration, antibiotic delivery, and vasopressors, if needed. This article has reviewed the different possible mechanisms found for sepsis-associated thrombocytopenia, going from the most acknowledged one as decreased platelet production to the potential aftermath of sepsis itself as disseminated intravascular coagulation (DIC). This article has also discussed the future treatment for patients suffering from thrombocytopenia and sepsis, going from phase I and II trials as GI antagonists to the well-known drug aspirin as a possible treatment for this problem.

摘要

脓毒症是由宿主对感染的失调反应导致的危及生命的器官功能衰竭,占医院死亡率的15.6%。无论疑似或确诊,脓毒症最常见的体征和症状是低血压、呼吸急促、发热和白细胞增多。包括一个主要症状,血小板减少是脓毒症患者不良预后的独立预测指标,会增加其死亡率和在重症监护病房(ICU)的住院时间。到目前为止,针对这个问题的现行治疗方法是确保气道通畅、治疗低氧血症,并在需要时提供血管通路以进行补液、给予抗生素和血管加压药。本文回顾了脓毒症相关性血小板减少症的不同可能机制,从最公认的血小板生成减少到脓毒症本身可能的后果如弥散性血管内凝血(DIC)。本文还讨论了血小板减少症和脓毒症患者的未来治疗方法,从作为胃肠道拮抗剂的I期和II期试验药物到作为该问题可能治疗方法的知名药物阿司匹林。

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