纤溶酶与手术部位感染中的免疫机制分析  

Analysis of Immune Mechanism in Plasmin and Surgical Site Infection

作　　者：雷浥存 LEI Yicun(School of Medicine,Huanghuai University,Zhumadian,Henan Province,463000 China)

机构地区：[1]黄淮学院医学院,河南驻马店463000

出　　处：《中外医疗》2022年第10期194-198,共5页China & Foreign Medical Treatment

摘　　要：手术部位感染(SSI)会产生大范围的经济压力,使得个体患者的发病率和病死率增加。目前主要的预防干预方案是应用抗生素药物,但这些药物的临床效果具有一定的不良性,尤其是遇到抗生素耐药微生物时效果更差。因此,探索抗菌剂辅助治疗新方法的需求更加强烈。纤溶酶以及纤溶酶原激活系统在免疫功能方面的表现比较复杂。纤溶酶的免疫血栓形成机制和凝血系统密切相关,对免疫系统的影响比较复杂,但并非一直有正向效用。氨甲环酸(TXA)作为一种抗纤溶药物,能够抑制纤溶酶原到纤溶酶的转化过程。TXA对于暴露患者的SSI减少效果已经得到了临床试验的证实,但其作用机制和程度还未得到全面的认识。其机制可能是通过减少局部伤口血肿、减少同种异体输血或直接免疫调节发挥作用。虽然,TXA可能成为减少SSI的安全且普遍适用的药物,但是仍然缺乏大型临床试验加以验证。SSI generates widespread economic pressures that increase morbidity and mortality in individual patients.At present,the main preventive intervention program is the use of antibiotics,but the clinical effects of these drugs have certain adverse effects,especially when they encounter antibiotic-resistant microorganisms.Therefore,there is an even stronger need to explore new approaches to antibacterial adjunctive therapy.The expression of plasmin and plasminogen activation system in immune function is more complex.The immune thrombosis mechanism of plasmin is closely related to the coagulation system,and its impact on the immune system is complex,but it does not always have a positive effect.As an antifibrinolytic drug,TXA can inhibit the conversion of plasminogen to plasmin.The SSI reduction effect of TXA in exposed patients has been confirmed by clinical trials,but its mechanism and extent of action have not been fully understood.The mechanism may be through reducing local wound hematoma,reducing allogeneic blood transfusion,or direct immunomodulation.Although TXA may become a safe and universally applicable drug for reducing SSI,large clinical trials are still lacking.

关 键 词：抗纤溶药物 纤溶酶 SSI 免疫 TXA 

分 类 号：R4[医药卫生—临床医学]