Coloretti Irene, Corcione Antonio, De Pascale Gennaro, Donati Abele, Forfori Francesco, Marietta Marco, Panigada Mauro, Simioni Paolo, Tascini Carlo, Viale Pierluigi, Girardis Massimo
Anaesthesiology and Intensive Care Department, University Hospital of Modena, University of Modena, Reggio Emilia, Modena, Italy.
Department of Critical Care, AORN Ospedali Dei Colli, Naples, Italy.
J Anesth Analg Crit Care. 2025 Apr 14;5(1):21. doi: 10.1186/s44158-025-00243-0.
Protein C (PC) plays a crucial role in modulating inflammation and coagulation in sepsis. Its anticoagulant and cytoprotective properties are critical in mitigating sepsis-induced coagulopathy, which is associated with high mortality rates. In sepsis, low levels of PC are associated with an elevated risk of multiple organ dysfunction and increased mortality. Routine monitoring of PC levels is not widely implemented but appears relevant in selected populations, such as patients with purpura fulminans, sepsis-induced coagulopathy (SIC), disseminated intravascular coagulopathy (DIC) or hyperinflammatory septic shock phenotypes. Treatment with PC has been limited to PC concentrate approved for paediatric use in congenital PC deficiencies and purpura fulminans, while the efficacy of PC supplementation in sepsis remains a subject of debate. Considering the physiological significance of PC and its role in sepsis pathophysiology, additional studies are necessary to fully elucidate its therapeutic efficacy in specific clinical settings.
蛋白C（PC）在调节脓毒症中的炎症和凝血过程中起着关键作用。其抗凝和细胞保护特性对于减轻脓毒症诱导的凝血病至关重要，而脓毒症诱导的凝血病与高死亡率相关。在脓毒症中，低水平的PC与多器官功能障碍风险升高和死亡率增加有关。虽然常规监测PC水平尚未广泛实施，但在特定人群中似乎具有相关性，例如暴发性紫癜、脓毒症诱导的凝血病（SIC）、弥散性血管内凝血（DIC）或高炎症性感染性休克表型的患者。PC的治疗仅限于已批准用于治疗先天性PC缺乏症和暴发性紫癜的儿科用PC浓缩物，而PC补充剂在脓毒症中的疗效仍存在争议。考虑到PC的生理意义及其在脓毒症病理生理学中的作用，需要进行更多研究以充分阐明其在特定临床环境中的治疗效果。
