细胞焦亡在脓毒症凝血障碍中的作用研究进展  

Research progress on the role of pyroptosis in sepsis-related coagulation disorder

作　　者：陈睿驰 卢尧 文爱清 Chen Ruichi;Lu Yao;Wen Aiqing(Department of Blood Transfusion,Daping Hospital,Army Medical University,Chongqing 400042,China)

机构地区：[1]陆军军医大学大坪医院输血科,重庆400042

出　　处：《中华危重病急救医学》2024年第7期768-773,共6页Chinese Critical Care Medicine

基　　金：国家自然科学基金(82172137,81971815);陆军特色医学中心临床医学技术创新能力培养计划(50121-3954)。

摘　　要：脓毒症是一种常见的严重感染疾病,其伴随的凝血功能障碍可以引起弥散性血管内凝血(DIC)和器官功能衰竭,导致病死率显著升高。细胞焦亡是一种由天冬氨酸特异性半胱氨酸蛋白酶1(caspase-1)介导的经典途径、caspase-4/caspase-5/caspase-11介导的非经典途径及效应分子GSDM(一种与焦亡相关的保守蛋白)家族成员共同导致的细胞程序性死亡方式。近年来研究表明,细胞焦亡对于脓毒症凝血障碍的发展具有重要作用。细胞焦亡导致的细胞质膜孔形成、细胞肿胀、质膜破裂、含有促凝活性内容物的释放和活性增强,促进了脓毒症系统性凝血激活及DIC的发展。因此,探讨细胞焦亡在脓毒症凝血障碍中的作用和分子机制对于脓毒症的防治具有重要意义。本文对细胞焦亡和脓毒症凝血障碍机制,以及细胞焦亡在脓毒症凝血障碍中的作用和机制进行综述,以期为脓毒症相关研究提供新的思路。Sepsis is a common and severe infectious disease,and its associated coagulation dysfunction can cause disseminated intravascular coagulation(DIC)and organ failure,leading to a significant increase in mortality.Pyroptosis is a form of programmed cell death mediated by caspase-1 in the classical pathway and caspase-4/caspase-5/caspase-11 in the non-classical pathway,along with the effector molecule gasdermin(GSDM)family.Recent studies have shown that pyroptosis plays an important role in the development of coagulation disorders in sepsis.Pyroptosis leads to the formation of cytoplasmic membrane pores,cell swelling and membrane rupture,as well as the release and enhanced activity of procoagulant contents,strongly promoting the development of systemic coagulation activation and DIC in sepsis.Therefore,exploring the role and molecular mechanisms of pyroptosis in sepsis-related coagulation disorders is of great significance for the prevention and treatment of sepsis.This article provides a review of the mechanisms involved in pyroptosis and coagulation disorders in sepsis,as well as the role and mechanisms of pyroptosis in sepsis-associated coagulation disorders to provide new ideas for sepsis related research.

关 键 词：细胞焦亡 脓毒症 凝血障碍 弥散性血管内凝血 

分 类 号：R459.7[医药卫生—急诊医学]