微血管COVID-19肺血管阻塞性血栓炎症综合征。COVID-19患者静脉血栓栓塞的预防

A. Sugraliyev, Рlinio Cirillo
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摘要

在这篇综述中,作者描述了由Ciceri F等人领导的意大利多学科团队提出的非典型急性呼吸窘迫综合征病因MicroCLOTS(微血管COVID-19肺血管阻塞性血栓炎症综合征)的新概念。Ciceri F,等。假设,在易感个体中,肺泡病毒损伤之后是炎症反应和微血管肺血栓形成。这种进行性内皮血栓炎症综合征也可累及脑和其他重要器官的微血管床,导致多器官衰竭和死亡。此外,由于Virchow三联体的激活,COVID-19患者经常发生大血管静脉血栓形成。通过下肢静脉超声检查和完整的尸检研究,确认新冠肺炎患者微血管和大血管血栓形成。本研究结果提示低分子肝素(nadroparin、依诺肝素)和氟达肝素钠预防COVID-19住院患者静脉血栓形成的重要性。关键词:COVID-19,典型急性呼吸窘迫综合征,MicroCLOTS(微血管COVID-19肺血管阻塞性血栓炎症综合征),血栓形成,止血
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome. Prevention of venous thromboembolism in patients with COVID-19
In this review, the authors describe the new concept of MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome) - proposed by Italian multidisciplinary team headed by Ciceri F, et al. as the cause of atypical acute respiratory distress syndrome. Ciceri F, etal. hypothesise that, in predisposed individuals, alveolar viral damage is followed by an inflammatory reaction and by microvascular pulmonary thrombosis. This progressive endothelial thromboinflammatory syndrome may also involve the microvascular bed of the brain and other vital organs, leading to multiple organ failure and death. In addition, patients with COVID-19 often develop macrovascular venous thrombosis as a result of the activation of the Virchow triad. Microvascular and macrovascular thrombosis development in patients with COVID-19 is confirmed by ultrasound examination of the veins of the lower extremities and complete autopsy study. The data obtained indicate the importance of the prevention of venous thrombosis with LMWH (nadroparin, enoxaparin) and Fondaparinux sodium in all hospitalized patients with COVID-19. Keywords: COVID-19, аtypical acute respiratory distress syndrome, MicroCLOTS (microvascular COVID-19 lung vessels obstructive thromboinflammatory syndrome), thrombosis, hemostasis.
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