Anaesthesiology and Intensive Care Department, University Hospital of Modena, University of Modena, Reggio Emilia, Italy.
Institute of Intensive Care Medicine, University Hospital Zurich, Zurich, Switzerland.
Intensive Care Med. 2024 Oct;50(10):1580-1592. doi: 10.1007/s00134-024-07586-2. Epub 2024 Sep 2.
The interplay between the immune system, coagulation, and endothelium is critical in regulating the host response to infection. However, in sepsis and other critical illnesses, a dysregulated immune response can lead to excessive alterations in these mechanisms, resulting in coagulopathy, endothelial dysfunction, and multi-organ dysfunction. This review aims to provide a comprehensive analysis of the pathophysiological mechanisms that govern the complex interplay between immune dysfunction, endothelial dysfunction, and coagulation in sepsis. It emphasises clinical significance, evaluation methods, and potential therapeutic interventions. Understanding these mechanisms is essential for developing effective treatments that can modulate the immune response, mitigate thrombosis, restore endothelial function, and ultimately improve patient survival.
免疫系统、凝血和内皮之间的相互作用对于调节宿主对感染的反应至关重要。然而，在脓毒症和其他危重病中，失调的免疫反应会导致这些机制的过度改变，从而导致凝血功能障碍、内皮功能障碍和多器官功能障碍。本综述旨在对脓毒症中免疫功能障碍、内皮功能障碍和凝血之间复杂相互作用的病理生理机制进行全面分析。它强调了临床意义、评估方法和潜在的治疗干预措施。了解这些机制对于开发有效的治疗方法至关重要，这些方法可以调节免疫反应、减轻血栓形成、恢复内皮功能，最终提高患者的生存率。
