新型评分系统及血栓四项在脓毒症性凝血病中的应用研究进展
Research Progress on the Application of the New Scoring System and the Four Thrombosis Indicators in Sepsis-Induced Coagulopathy
DOI: 10.12677/acm.2026.1641280, PDF,    科研立项经费支持
作者: 卫艳锋*：延安大学延安医学院，陕西 延安；李锐成*：空军军医大学唐都医院检验科，陕西 西安；连建奇, 李 璟, 胡海峰, 李孝锋, 王天平, 薛智昱, 姜 泓, 张 颖, 杜 虹#：空军军医大学唐都医院传染科，陕西 西安
关键词: 脓毒症性凝血病；弥散性血管内凝血；凝血标志物；血管内皮损伤；血栓四项；Sepsis-Induced Coagulopathy； Disseminated Intravascular Coagulation； Coagulation Markers； Vascular Endothelial Injury； Four Thrombosis Indicators
摘要: 脓毒症是指宿主对感染的反应失调进而导致危及生命的器官功能障碍。脓毒症性凝血病(Sepsis-Induced Coagulopathy, SIC)是脓毒症的严重并发症之一，以全身炎症反应导致的凝血功能障碍紊乱为核心特征。传统的凝血功能评估，虽能反映机体部分凝血状态，但其敏感性、特异性不足。近年来国内外先后提出针对DIC及SIC的新型评分系统，部分新型凝血标志物，如“血栓四项”在临床的应用亦逐渐得到重视。有研究表明，血栓调节蛋白(Thrombomodulin, TM)、凝血酶–抗凝血酶复合物(Thrombin-Antithrombin Complex, TAT)、纤溶酶-α2纤溶酶抑制物复合物(α2-Plasmininhibitor-Plasmin Complex, PIC)和组织型纤溶酶原激活物–纤溶酶原激活抑制物-1 (Tissue Plasminogen Activator-Plasminogen Activator Inhibitor-1 Complex, t-PAIC)的异常表达有助于反映脓毒症患者疾病早期的血管内皮损伤及凝血紊乱严重程度。本文将围绕上述四种新型凝血标志物及最新提出的SIC评分系统的临床应用进展及前景进行综述。
Abstract: Sepsis refers to a life-threatening organ dysfunction caused by a dysregulated host response to infection. Sepsis-induced coagulopathy (SIC) is one of the severe complications of sepsis, characterised primarily by coagulation disorders resulting from systemic inflammatory responses. Traditional assessment of coagulation function is capable of reflecting certain coagulation states of the body, while it lacks sufficient sensitivity and specificity. In recent years, new scoring systems targeting DIC and SIC have been proposed both domestically and internationally, and some novel coagulation markers, such as the “Four Thrombosis Indicators”, have gradually received clinical attention. Some studies indicate that abnormal expression of thrombomodulin (TM), Thrombin-Antithrombin Complex (TAT), α2-Plasmin Inhibitor-Plasmin Complex (PIC), and Tissue Plasminogen Activator-Plasminogen Activator Inhibitor-1 Complex (t-PAIC) can help reflect early endothelial injury and the severity of coagulation disorders in patients with sepsis. This manuscript reviews the clinical application progress and prospects of the aforementioned four novel coagulation markers and the recently proposed SIC scoring system.
文章引用：卫艳锋, 李锐成, 连建奇, 李璟, 胡海峰, 李孝锋, 王天平, 薛智昱, 姜泓, 张颖, 杜虹. 新型评分系统及血栓四项在脓毒症性凝血病中的应用研究进展[J]. 临床医学进展, 2026, 16(4): 552-560. https://doi.org/10.12677/acm.2026.1641280

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