非抗体介导输血相关急性肺损伤的研究进展  

Research progress on non-antibody-mediated transfusion-related acute lung injury

作　　者：周亚玲[1] 李玲 刘忠 Zhou Yaling;Li Ling;Liu Zhong(Department of Blood Transfusion,the Sixth People's Hospital Chengdu,Chengdu 610051,Sichuan Province,China;Institute of Blood Transfusion,Chinese Academy of Medical Sciences Key Laboratory of Transfusion Adverse Reactions,Chinese Academy of Medical Sciences,Chengdu 610052,Sichuan Province,China)

机构地区：[1]成都市第六人民医院输血科,成都610051 [2]中国医学科学院输血研究所,中国医学科学院输血不良反应研究重点实验室,成都610052

出　　处：《国际输血及血液学杂志》2023年第5期455-460,F0003,共7页International Journal of Blood Transfusion and Hematology

基　　金：中国医学科学院医学与健康科技创新工程项目(2021-1-I2M-060)。

摘　　要：输血相关急性肺损伤(TRALI)是输血相关性死亡的主要原因之一。在TRALI发病机制的"二次打击"学说中,根据第2次打击因素不同,可将TRALI分为抗体介导和非抗体介导TRALI。抗体在TRALI发病中的作用较为明确,而生物活性脂质、可溶性CD40配体(sCD40L)、微粒等非抗体因素在血液成分保存过程中虽有积累,但是其在TRALI发病中的确切机制尚无定论。笔者拟就生物反应调节剂(BRM)和血液成分的贮存损伤等非抗体因素在TRALI中的研究进展进行综述,旨在为TRALI的防治提供新思路。Transfusion-related acute lung injury(TRALI)is one of the leading causes of transfusion-related death.In the"two-hit"theory of TRALI pathogenesis,TRALI can be classified as antibody-mediated or non-antibody-mediated TRALI according to different second-hit factors.The role of antibodies in pathogenesis of TRALI is relatively clear,while the exact mechanisms of non-antibody factors,like bioactive lipids,soluble CD40 ligand(sCD40L),and microparticles,which accumulate during blood components storage,are still inconclusive.This article intends to review research progress of non-antibody factors in TRALI,such as biological response modifier(BRM)and storage damage of blood components,in order to provide new ideas for the prevention and treatment of TRALI.

关 键 词：输血相关的急性肺损伤 神经酰胺类 溶血磷脂酰胆碱类 CD40配体 细胞外囊泡 红细胞 陈旧 

分 类 号：R457.1[医药卫生—治疗学]