成人重症相关血栓性微血管病的病理生理改变与诊断和治疗进展  

Advances in pathophysiology,diagnosis and treatment of adult severe-associated thrombotic microangiopathy

作　　者：许华 王勇强[1] 高红梅[1] Xu Hua;Wang Yongqiang;Gao Hongmei(Department of Critical Care Medicine,Tianjin First Center Hospital,Key Laboratory for Critical Care Medicine of the Ministry of Health,Emergency Medicine Research Institute,Tianjin 300192,China)

机构地区：[1]天津市第一中心医院重症医学科,天津市急救医学研究所,国家卫健委危重病急救医学重点实验室,天津300192

出　　处：《中华危重病急救医学》2023年第12期1335-1339,共5页Chinese Critical Care Medicine

基　　金：天津市医学重点学科建设项目(TJYXZDXK-013A);天津市科技计划项目(21JCYBJC00090,22JCQNJC00420);天津市卫生健康科技项目(ZC20012,TJWJ2022XK023)。

摘　　要：血栓性微血管病(TMA)是一组高度异质性,急、重性临床病理综合征,以微血管病性溶血性贫血(MAHA)、血小板减少和终末器官缺血性损伤为主要临床特征。TMA具有病情凶险、多器官受累和高病死率的特点,重症患者需要入住重症监护病房(ICU)进行器官功能支持治疗。早期快速评估和鉴别诊断TMA,并给予适时有效的治疗是改善患者预后的关键。本文从成人重症相关TMA的病理生理改变、诊断和鉴别诊断及治疗方面的相关进展开展综述。Thrombotic microangiopathy(TMA)is a group of highly heterogeneous,acute and severe clinicopathological syndromes,characterized by microangiopathic hemolytic anemia(MAHA),thrombocytopenia and ischemic injury of end organs.TMA has the characteristics of dangerous condition,multiple organ involvement and high mortality.Patients with severe TMA need to be admitted to intensive care unit(ICU)for organ function support therapy.Early and rapid evaluation,differential diagnosis,and timely and effective treatment are the key to improve the prognosis of TMA patients.Here,we review the pathophysiological changes,diagnosis differential diagnosis,and treatment of the severe TMA in adult.

关 键 词：血栓性微血管病 血栓性血小板减少性紫癜 溶血尿毒综合征 HELLP综合征 诊断 成人 

分 类 号：R543[医药卫生—心血管疾病]