恢复期去红细胞成分血治疗重症严重急性呼吸综合征和新型冠状病毒肺炎的机制及安全性探索  

Exploration on the therapeutic mechanisms and safety of blood components of convalescents without erythrocytes on severe acute respiratory syndrome and coronavirus disease 2019

作　　者：冯伟生[1] 杜斌 冯宝举 Feng Weisheng;Du Bin;Feng Baoju(Department of Emergency,Lianyungang Hospital of Traditional Chinese Medicine,Affiliated Lianyungang Hospital of Nanjing University of Chinese Medicine,Lianyungang 222000,Jiangsu,China;Department of Medical Intensive Care Unit,Peking Union Medical College Hospital,Beijing 100730,China;Department of Oncology Internal Medicine,the First Hospital of China Medical University,Shenyang 110000,Liaoning,China)

机构地区：[1]连云港市中医院南京中医药大学连云港附属医院急诊医学科,江苏连云港222000 [2]中国医学科学院北京协和医院内科ICU,北京100730 [3]中国医科大学第一附属医院肿瘤内科,沈阳110000

出　　处：《中华危重病急救医学》2020年第6期652-657,共6页Chinese Critical Care Medicine

基　　金：南京医科大学江苏康达医药卫生发展研究院科研项目(NYKDKJ2015015);江苏省连云港市临床重点专科建设项目(2020-35)。

摘　　要：2019新型冠状病毒肺炎(新冠肺炎)席卷全球,其传染性强,病死率高,目前仍缺乏特效治疗方法。不能有效清除病毒是新冠肺炎患者死亡的主要原因,而细胞免疫在机体清除冠状病毒的过程中发挥着决定性作用,因此有必要在血浆治疗基础上对细胞免疫进行研究。恢复期去红细胞成分血中含有血液中细胞免疫和体液免疫的全部成分,这一方法较血浆治疗增加了细胞免疫治疗部分。目前研究表明,中性粒细胞、特异性抗体、干扰素、血小板、特异性效应细胞及记忆细胞等在清除冠状病毒的免疫过程中均具有不可替代的作用。本文对成分血中以上各要素在输注安全性、治疗机制及在免疫紊乱和过度炎症反应干预方面等作用进行了综述,以期为新冠肺炎的救治提供一个可选的参考方案。Coronavirus disease 2019(COVID-19)is sweeping the world with strong infectivity and high mortality,but by now,we still lack specific treatment.The leading cause of death from COVID-19 is failure to eliminate those viruses effectively.Cellular immunity plays a crucial role in the body's elimination of coronavirus,so it is necessary to study cellular immunity on the basis of plasma therapy.Blood components of convalescents without erythrocytes contains all the components of cellular immunity and humoral immunity in blood.Current studies had shown that all neutrophils,specific antibodies,interferons,platelets,specific effect cells and memory cells,play irreplaceable roles in the immune process of eradicating coronavirus.This article summarizes the infusion safety,therapeutic mechanism of all above components,and their effects on immunologic derangement and excessive inflammatory response,in order to provide an alternative reference for the treatment of COVID-19.

关 键 词：严重急性呼吸综合征 新型冠状病毒肺炎 成分血 被动免疫 

分 类 号：R563.8[医药卫生—呼吸系统] R563.1[医药卫生—内科学]