Infection and inflammation and the coagulation system

被引:402
作者
Levi, M
Keller, TT
van Gorp, E
ten Cate, H
机构
[1] Univ Amsterdam, Acad Med Ctr, Dept Vasc Med & Internal Med, NL-1105 AZ Amsterdam, Netherlands
[2] Slotervaart Hosp, Dept Internal Med, Amsterdam, Netherlands
[3] Acad Hosp Maastricht, Dept Internal Med, Maastricht, Netherlands
关键词
cytokines; hemostasis; infection/inflammation;
D O I
10.1016/S0008-6363(02)00857-X
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Severe infection and inflammation almost invariably lead to hemostatic abnormalities, ranging from insignificant laboratory changes to severe disseminated intravascular coagulation (DIC). Systemic inflammation results in activation of coagulation, due to tissue factor-mediated thrombin generation, downregulation of physiological anticoagulant mechanisms, and inhibition of fibrinolysis. Proinflammatory cytokines play a central role in the differential effects on the coagulation and fibrinolysis pathways. Vice-versa, activation of the coagulation system may importantly affect inflammatory responses by direct and indirect mechanisms. Apart from the general coagulation response to inflammation associated with severe infection, specific infections may cause distinct features, such as hemorrhagic fever or thrombotic microangiopathy. The relevance of the cross-talk between inflammation and coagulation is underlined by the promising results in the treatment of severe systemic infection with modulators of coagulation and inflammation. (C) 2003 European Society of Cardiology. Published by Elsevier B.V. All rights reserved.
引用
收藏
页码:26 / 39
页数:14
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