COVID-19 associated thromboinflammation of renal capillary: potential mechanisms and treatment.
COVID-19 associated thromboinflammation of renal capillary: potential mechanisms and treatment.
复制标题
COVID-19 相关的肾毛细血管血栓炎症：潜在机制和治疗。
DOI：
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发表时间：
2020
期刊：
影响因子：
--
通讯作者：
Jialan Shi
中科院分区：
文献类型：
--
作者：
Xiaojing Chen;Chengyuan Yu;Haijiao Jing;Chunxu Wang;Xinyi Zhao;Jinming Zhang;Shuoqi Zhang;Huan Liu;Rujuan Xie;Jialan Shi
由严重急性呼吸综合征冠状病毒2型（SARS-CoV-2）感染的2019冠状病毒病（COVID-19）已成为一种全球性流行性疾病，具有高发病率和高死亡率。炎症和血栓形成是其主要表现。肾脏作为血液滤过代谢的重要器官，在过滤COVID-19高炎症、高粘稠血液时，容易发生堵塞和破坏，导致大量蛋白质流失，加重血液浓缩，进而加重COVID-19高凝状态，这可以解释红细胞聚集阻塞毛细血管腔的现象，也是肾成为第二大肾的主要原因。参与机关。本文就炎症风暴、内皮损伤、磷脂酰丝氨酸表达、细胞外陷阱释放等病理生理机制在COVID-19感染所致肾毛细血管血栓形成中的作用进行综述。同时，针对上述机制，提出了抗血栓治疗的潜在靶点，并对患者进行分级管理，根据病情的严重程度合理用药及时间的选择。支持入院前预防血栓形成，出院后继续抗凝治疗和药物选择的观点。提示危重症患者肾脏疾病的对症支持治疗应结合抗栓治疗理念。最终目标是减少肾脏疾病的发生和发展，为当前肾脏疾病的COVID-19管理提供方向，降低COVID-19的死亡率。
Coronavirus disease 2019 (COVID-19) infected by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has become a global pandemic disease with high morbidity and mortality. Inflammatory and thrombosis are its main manifestations. As an important organ of hemofiltration metabolism, the kidney is prone to blockage and destruction when filter high inflammatory and high viscous blood of COVID-19, resulting in the loss of a large amount of protein, aggravating blood concentration, and then worsening COVID-19 hypercoagulability, which may explain the phenomenon of erythrocytes aggregation blocking the capillary lumen and the main reason why the kidney has become the second largest involvement organs. Therefore, this review discusses the effects of pathophysiological mechanisms such as inflammatory storm, endothelial injury, phosphatidylserine expression, extracellular traps release on renal capillary thrombosis caused by COVID-19 infection. Meanwhile, in view of the above mechanisms, we put forward the potential targets of antithrombotic therapy, and graded management of patients, reasonable use of drugs according to the severity of the disease and the choice of time. And we support the view of prevention of thrombus before admission, continuous anticoagulation and drug choice after discharge. It is suggested that the symptomatic and supportive treatment of renal disease in critically ill patients should be combined with the concept of antithrombotic therapy. The ultimate goal is to reduce the occurrence and development of kidney disease, provide direction for the current management of COVID-19 with kidney disease, and reduce the mortality of COVID-19.
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DOI：
10.3760/cma.j.cn112338-20200427-00659
发表时间：
2020-12
影响因子：
--
作者：
Chaolin Huang;Ye-ming Wang;Xing-wang Li;L. Ren;Jianping Zhao;Y. Hu;Li Zhang;Guohui Fan;
通讯作者：
Chaolin Huang;Ye-ming Wang;Xing-wang Li;L. Ren;Jianping Zhao;Y. Hu;Li Zhang;Guohui Fan;
影响因子：
37.8
作者：
Neumann, FJ;Marx, N;Schomig, A
通讯作者：
Schomig, A
影响因子：
7.5
作者：
Mahan, Charles E.;Fisher, Maxine D.;Spyropoulos, Alex C.
通讯作者：
Spyropoulos, Alex C.
影响因子：
8
作者：
Zuo, Yu;Yalavarthi, Srilakshmi;Knight, Jason S.
通讯作者：
Knight, Jason S.
COVID-19 肺炎患者的肾脏受累和早期预后
影响因子：
13.6
作者：
Pei, Guangchang;Zhang, Zhiguo;Xu, Gang
通讯作者：
Xu, Gang