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中华临床医师杂志(电子版) ›› 2021, Vol. 15 ›› Issue (04) : 302 -307. doi: 10.3877/cma.j.issn.1674-0785.2021.04.012

所属专题: 急危重症

综述

血小板及其表面受体配体在脓毒症凝血病中作用的研究进展
茅敏1, 李秀2, 王子丹1, 单亮1,()   
  1. 1. 266003 山东青岛,青岛大学附属医院重症医学科
    2. 266003 山东青岛,青岛大学附属医院内科门诊
  • 收稿日期:2021-03-16 出版日期:2021-04-15
  • 通信作者: 单亮
  • 基金资助:
    青岛大学附属医院“临床医学+X”工程项目

Role of platelets and their surface receptors and ligands in septic coagulopathy

Min Mao1, Xiu Li2, Zidan Wang1, Liang Shan1()   

  1. 1. Intensive Care Unit, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
    2. Department of Outpatient, the Affiliated Hospital of Qingdao University, Qingdao 266003, China
  • Received:2021-03-16 Published:2021-04-15
  • Corresponding author: Liang Shan
引用本文:

茅敏, 李秀, 王子丹, 单亮. 血小板及其表面受体配体在脓毒症凝血病中作用的研究进展[J/OL]. 中华临床医师杂志(电子版), 2021, 15(04): 302-307.

Min Mao, Xiu Li, Zidan Wang, Liang Shan. Role of platelets and their surface receptors and ligands in septic coagulopathy[J/OL]. Chinese Journal of Clinicians(Electronic Edition), 2021, 15(04): 302-307.

血小板是小的无核血细胞,是重要的止血物质,近年研究发现血小板在炎症和免疫反应中起着至关重要的作用。脓毒症期间,多种因素刺激血小板活化,特别是脂多糖,其通过刺激血小板分泌来促进血小板活化并增强血小板聚集。活化后的血小板表达多种受体,其中P-选择素在炎症反应中起着始动作用,而GP Ⅱb/Ⅲa活化并与纤维蛋白原结合是各种原因所致的血小板聚集的共同途径和必需环节,两者在脓毒症凝血病中发挥着至关重要的作用。活化后的血小板与白细胞、内皮细胞相互作用,催化过度炎症反应和凝血功能失调,导致弥散性血管内凝血状态和微循环血栓形成,最终导致多器官功能衰竭。另外活化的血小板脱落血小板产物,即血小板衍生膜微粒,其增强了炎症和凝血。本文综述了目前血小板及其表面受体配体在脓毒症凝血病中作用的研究进展。

Platelets are small anuclear cells that have a critical role in hemostasis. Recent studies have found that platelets play an important role in inflammation and immune response. In sepsis, multiple factors stimulate platelet activation, especially the lipopolysaccharide, which promotes platelet activation and enhances platelet aggregation by stimulating platelet secretion. The activated platelets express a variety of receptors, among which P-selectin plays an initiating role in the inflammatory response. Moreover, GP Ⅱb/Ⅲa activation and binding to fibrinogen is a common pathway and essential step for platelet aggregation caused by various causes. Both P-selectin and GP Ⅱb/Ⅲa play a vital role in septic coagulopathy. Activated platelets interact with leukocytes and endothelial cells, catalyzing excessive inflammatory response and coagulation dysfunction, leading to disseminated intravascular coagulation and microcirculatory thrombosis, and eventually causing multiple organ failure. In addition, activated platelets shed platelet products, known as platelet-derived microparticles, which enhance inflammation and coagulation. This paper reviews the research progress in the understanding of the role of platelets and their surface receptors and ligands in septic coagulopathy.

1
中华医学会重症医学分会.中国严重脓毒症/脓毒性休克治疗指南(2014) [J]. 中华内科杂志, 2015, 54(6): 557-581
2
Seymour CW, Liu VX, Iwashyna TJ, et al. Assessment of clinical criteria for sepsis: for the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3) [J]. JAMA, 2016, 315(8): 762-774.
3
Semeraro N, Ammollo CT, Semeraro F, et al. Sepsis, thrombosis and organ dysfunction [J]. Thromb Res, 2012, 129(3): 290-295.
4
Levi M, Poll T. Coagulation in patients with severe sepsis [J]. Semin Thromb Hemost, 2015, 41(1): 9-15.
5
钟林翠, 宋景春. 脓毒症时血小板的功能改变及抗血小板治疗的研究进展 [J]. 医学研究生学报, 2019, 32(2): 196-200.
6
Coppinger JA, Cagney G, Toomey S, et al. Characterization of the proteins released from activated platelets leads to localization of novel platelet proteins in human atherosclerotic lesions [J]. Blood, 2004, 103(6): 2096-2104.
7
Greco E, Lupia E, Bosco O, et al. Platelets and multi-organ failure in sepsis [J]. Int J Mol Sci, 2017, 18(10), 2200.
8
Thomas MR, Storey RF. The role of platelets in inflammation [J]. Thromb Haemost, 2015, 114(3): 449-458.
9
Engelmann B, Massberg S. Thrombosis as an intravascular effector of innate immunity [J]. Nat Rev Immunol, 2013, 13(1): 34-45.
10
Gaertner F, Massberg S. Blood coagulation in immunothrombosis-At the frontline of intravascular immunity [J]. Semin Immunol, 2016, 28(6): 561-569.
11
Varon D, Shai E. Platelets and their microparticles as key players in pathophysiological responses [J]. J Thromb Haemost, 2015, 13 Suppl 1: S40-46.
12
Wang Y, Ouyang Y, Liu B, et al. Platelet activation and antiplatelet therapy in sepsis: a narrative review [J]. Thromb Res, 2018, 166: 28-36.
13
Walborn A, Rondina M, Mosier M, et al. Endothelial dysfunction is associated with mortality and severity of coagulopathy in patients with sepsis and disseminated intravascular coagulation [J]. Clin Appl Thromb Hemost, 2019, 25: 1076029619852163.
14
单亮, 李翠萍, 李秀, 等. 抗凝治疗应成为细菌感染所致严重脓毒症的标准治疗方案 [J]. 中华危重病急救医学, 2016, 28(2): 104-105.
15
Semeraro N, Ammollo CT, Semeraro F, et al. Coagulopathy of acute sepsis [J]. Semin Thromb Hemost, 2015, 41(6): 650-658.
16
Iba T, Levy JH. Inflammation and thrombosis: roles of neutrophils, platelets and endothelial cells and their interactions in thrombus formation during sepsis [J]. J Thromb Haemost, 2018, 16(2): 231-241.
17
Cruz MA, Diacovo TG, Emsley J, et al. Mapping the glycoprotein Ib-binding site in the von willebrand factor A1 domain [J]. J Biol Chem, 2000, 275(25): 19098-19105.
18
Weyrich AS, Lindemann S, Zimmerman GA. The evolving role of platelets in inflammation [J]. J Thromb Haemost, 2003, 1(9): 1897-1905.
19
Varga-Szabo D, Pleines I, Nieswandt B. Cell adhesion mechanisms in platelets [J]. Arterioscler Thromb Vasc Biol, 2008, 28(3): 403-412.
20
Vardon Bounes F, Memier V, Marcaud M, et al. Platelet activation and prothrombotic properties in a mouse model of peritoneal sepsis [J]. Sci Rep, 2018, 8(1): 13536.
21
Wong CH, Jenne CN, Petri B, et al. Nucleation of platelets with blood-borne pathogens on Kupffer cells precedes other innate immunity and contributes to bacterial clearance [J]. Nat Immunol, 2013, 14(8): 785-792.
22
Cox D, Kerrigan SW, Watson SP. Platelets and the innate immune system: mechanisms of bacterial-induced platelet activation [J]. J Thromb Haemost, 2011, 9(6): 1097-1107.
23
Van der Poll T, Parker RI. Platelet activation and endothelial cell dysfunction [J]. Crit Care Clin, 2020, 36(2): 233-253.
24
Furie B, Furie BC. Thrombus formation in vivo [J]. J Clin Invest, 2005, 115(12): 3355-3362.
25
Nieswandt B, Watson SP. Platelet-collagen interaction: is GPVI the central receptor? [J]. Blood, 2003, 102(2): 449-461.
26
Jooss NJ, De Simone I, Provenzale I, et al. Role of platelet glycoprotein Ⅵ and tyrosine kinase syk in thrombus formation on collagen-like surfaces [J]. Int J Mol Sci, 2019, 20(11): 2788.
27
Herter JM, Rossaint J, Zarbock A. Platelets in inflammation and immunity [J]. J Thromb Haemost, 2014, 12(11): 1764-1775.
28
Offermanns S. Activation of platelet function through G protein-coupled receptors [J]. Circ Res, 2006, 99(12): 1293-1304.
29
Levi M. Platelets in sepsis [J]. Hematology, 2005, 10 Suppl 1: 129-131.
30
罗先明, 杨秋红, 魏菁, 等. 杀菌通透性增加蛋白体外抑制革兰阴性细菌脂多糖激活血小板的作用 [J]. 中国实验血液学杂志, 2012, 20(1): 129-132.
31
Shannon O. Platelet interaction with bacterial toxins and secreted products [J]. Platelets, 2015, 26(4): 302-308.
32
Zhang G, Han J, Welch EJ, et al. Lipopolysaccharide stimulates platelet secretion and potentiates platelet aggregation via TLR4/MyD88 and the cGMP-dependent protein kinase pathway [J]. J Immunol, 2009, 182(12): 7997-8004.
33
De Stoppelaar SF, Claushuis TA, Schaap MC, et al. Toll-like receptor signalling is not involved in platelet response to streptococcus pneumoniae in vitro or in vivo [J]. PLoS One, 2016, 11(6): e0156977.
34
陈蕊, 郭振辉. P-选择素与脓毒症 [J]. 广东医学, 2010, 31(23): 3144-3147.
35
Moore KL, Patel KD, Bruehl RE, et al. P-selectin glycoprotein ligand-1 mediates rolling of human neutrophils on P-selectin [J]. J Cell Biol, 1995, 128(4): 661-671.
36
Blann AD, Nadar SK, Lip GY. The adhesion molecule P-selectin and cardiovascular disease [J]. Eur Heart J, 2003, 24(24): 2166-2179.
37
Weyrich AS, Zimmerman GA. Platelets: signaling cells in the immune continuum [J]. Trends Immunol, 2004, 25(9): 489-495.
38
Ley K, Laudanna C, Cybulsky MI, et al. Getting to the site of inflammation: the leukocyte adhesion cascade updated [J]. Nat Rev Immunol, 2007, 7(9): 678-689.
39
Vandendries ER, Furie BC, Furie B. Role of P-selectin and PSGL-1 in coagulation and thrombosis [J]. Thromb Haemost, 2004, 92(3): 459-466.
40
Singbartl K, Forlow SB, Ley K. Platelet, but not endothelial, P-selectin is critical for neutrophil-mediated acute postischemic renal failure [J]. FASEB J, 2001, 15(13): 2337-2344.
41
Morrell CN, Aggrey AA, Chapman LM, et al. Emerging roles for platelets as immune and inflammatory cells [J]. Blood, 2014, 123(18): 2759-2767.
42
Weyrich AS, McIntyre TM, McEver RP, et al. Monocyte tethering by P-selectin regulates monocyte chemotactic protein-1 and tumor necrosis factor-alpha secretion. Signal integration and NF-kappa B translocation [J]. J Clin Invest, 1995, 95(5): 2297-2303.
43
Vieira-de-Abreu A, Campbell RA, Weyrich AS, et al. Platelets: versatile effector cells in hemostasis, inflammation, and the immune continuum [J]. Semin Immunopathol, 2012, 34(1): 5-30.
44
Wagner DD, Frenette PS. The vessel wall and its interactions [J]. Blood, 2008, 111(11): 5271-5281.
45
Russwurm S, Vickers J, Meier-Hellmann A, et al. Platelet and leukocyte activation correlate with the severity of septic organ dysfunction [J]. Shock, 2002, 17(4): 263-268.
46
Zarbock A, Singbartl K, Ley K. Complete reversal of acid-induced acute lung injury by blocking of platelet-neutrophil aggregation [J]. J Clin Invest, 2006, 116(12): 3211-3219.
47
Bennett JS. Structure and function of the platelet integrin alphaIIbbeta3 [J]. J Clin Invest, 2005, 115(12): 3363-3369.
48
Vincent JL, Yagushi A, Pradier O. Platelet function in sepsis [J]. Crit Care Med, 2002, 30(5 Suppl): S313-317.
49
Zmigrodzka M, Guzera M, Winnicka A. Flow cytometric assessment of activation of peripheral blood platelets in dogs with normal platelet count and asymptomatic thrombocytopenia [J]. Pol J Vet Sci, 2016, 19(2): 407-414.
50
Coller BS, Shattil SJ. The GPⅡb/Ⅲa (integrin alphaⅡbbeta3) odyssey: a technology-driven saga of a receptor with twists, turns, and even a bend [J]. Blood, 2008, 112(8): 3011-3025.
51
Pu Q, Wiel E, Corseaux D, et al. Beneficial effect of glycoprotein Ⅱb/Ⅲa inhibitor (AZ-1) on endothelium in Escherichia coli endotoxin-induced shock [J]. Crit Care Med, 2001, 29(6): 1181-1188.
52
Sharron M, Hoptay CE, Wiles AA, et al. Platelets induce apoptosis during sepsis in a contact-dependent manner that is inhibited by GPⅡb/Ⅲa blockade [J]. PLoS One, 2012, 7(7): e41549.
53
Akinosoglou K, Alexopoulos D. Use of antiplatelet agents in sepsis: a glimpse into the future [J]. Thromb Res, 2014, 133(2): 131-138.
54
Coppinger JA, Maguire PB. Insights into the platelet releasate [J]. Curr Pharm Des, 2007, 13(26): 2640-2646.
55
Zarbock A, Polanowska-Grabowska RK, Ley K. Platelet-neutrophil-interactions: linking hemostasis and inflammation [J]. Blood Rev, 2007, 21(2): 99-111.
56
Feng G, Yang X, Li Y, et al. LPS enhances platelets aggregation via TLR4, which is related to mitochondria damage caused by intracellular ROS, but not extracellular ROS [J]. Cell Immunol, 2018, 328: 86-92.
57
Kulkarni S, Dopheide SM, Yap CL, et al. A revised model of platelet aggregation [J]. J Clin Invest, 2000, 105(6): 783-791.
58
Sexton TR, Zhang G, Macaulay TE, et al. Ticagrelor reduces thromboinflammatory markers in patients with pneumonia [J]. JACC Basic Transl Sci, 2018, 3(4): 435-449.
59
Lu YC, Yeh WC, Ohashi PS. LPS/TLR4 signal transduction pathway [J]. Cytokine, 2008, 42(2): 145-151.
60
Andonegui G, Kerfoot SM, McNagny K, et al. Platelets express functional Toll-like receptor-4 [J]. Blood, 2005, 106(7): 2417-2423.
61
Brinkmann V, Zychlinsky A. Neutrophil extracellular traps: is immunity the second function of chromatin? [J]. J Cell Biol, 2012, 198(5): 773-783.
62
Andrews RK, Arthur JF, Gardiner EE. Neutrophil extracellular traps (NETs) and the role of platelets in infection [J]. Thromb Haemost, 2014, 112(4): 659-665.
63
王怡宁, 汪松, 陆元兰, 等. 血小板在脓毒症及其所致器官功能障碍发病中作用的研究进展 [J]. 山东医药, 2018, 58(30): 100-102.
64
Andonegui G, Bonder CS, Green F, et al. Endothelium-derived Toll-like receptor-4 is the key molecule in LPS-induced neutrophil sequestration into lungs [J]. J Clin Invest, 2003, 111(7): 1011-1020.
65
Ma AC, Kubes P. Platelets, neutrophils, and neutrophil extracellular traps (NETs) in sepsis [J]. J Thromb Haemost, 2008, 6(3): 415-420.
66
Clark SR, Ma AC, Tavener SA, et al. Platelet TLR4 activates neutrophil extracellular traps to ensnare bacteria in septic blood [J]. Nat Med, 2007, 13(4): 463-469.
67
Kapoor S, Opneja A, Nayak L. The role of neutrophils in thrombosis [J]. Thromb Res, 2018, 170: 87-96.
68
Kaplan MJ, Radic M. Neutrophil extracellular traps: double-edged swords of innate immunity [J]. J Immunol, 2012, 189(6): 2689-2695.
69
Tanaka K, Koike Y, Shimura T, et al. In vivo characterization of neutrophil extracellular traps in various organs of a murine sepsis model [J]. PLoS One, 2014, 9(11): e111888.
70
Saffarzadeh M, Juenemann C, Queisser MA, et al. Neutrophil extracellular traps directly induce epithelial and endothelial cell death: a predominant role of histones [J]. PLoS One, 2012, 7(2): e32366.
71
Fuchs TA, Brill A, Duerschmied D, et al. Extracellular DNA traps promote thrombosis [J]. Proc Natl Acad Sci U S A, 2010, 107(36): 15880-15885.
72
Haselmayer P, Grosse-Hovest L, Von Landenberg P, et al. TREM-1 ligand expression on platelets enhances neutrophil activation [J]. Blood, 2007, 110(3): 1029-1035.
73
Ma YQ, Plow EF, Geng JG. P-selectin binding to P-selectin glycoprotein ligand-1 induces an intermediate state of alphaMbeta2 activation and acts cooperatively with extracellular stimuli to support maximal adhesion of human neutrophils [J]. Blood, 2004, 104(8): 2549-2556.
74
Blanks JE, Moll T, Eytner R, et al. Stimulation of P-selectin glycoprotein ligand-1 on mouse neutrophils activates beta 2-integrin mediated cell attachment to ICAM-1 [J]. Eur J Immunol, 1998, 28(2): 433-443.
75
Jenne CN, Kubes P. Platelets in inflammation and infection [J]. Platelets, 2015, 26(4): 286-292.
76
Salat A, Bodingbauer G, Boehm D, et al. Changes of platelet surface antigens in patients suffering from abdominal septic shock [J]. Thromb Res, 1999, 95(6): 289-294.
77
Kirschenbaum LA, Lopez WC, Ohrum P, et al. Effect of recombinant activated protein C and low-dose heparin on neutrophil-endothelial cell interactions in septic shock [J]. Crit Care Med, 2006, 34(8): 2207-2212.
78
Semple JW, Italiano JE, Jr., Freedman J. Platelets and the immune continuum [J]. Nat Rev Immunol, 2011, 11(4): 264-274.
79
Rossaint J, Margraf A, Zarbock A. Role of platelets in leukocyte recruitment and resolution of inflammation [J]. Front Immunol, 2018, 9: 2712.
80
Hidalgo A, Chang J, Jang JE, et al. Heterotypic interactions enabled by polarized neutrophil microdomains mediate thromboinflammatory injury [J]. Nat Med, 2009, 15(4): 384-391.
81
李霞, 单小鸥. 中性粒细胞与脓毒症 [J/OL]. 中华危重症医学杂志(电子版), 2011, 4(3): 187-192.
82
De Stoppelaar SF, Van't Veer C, Van der Poll T. The role of platelets in sepsis [J]. Thromb Haemost, 2014, 112(4): 666-677.
83
May AE, Kalsch T, Massberg S, et al. Engagement of glycoprotein .Ⅱb/Ⅲa (alpha(Ⅱb)beta3) on platelets upregulates CD40L and triggers CD40L-dependent matrix degradation by endothelial cells [J]. Circulation, 2002, 106(16): 2111-2117.
84
Opal SM, Van der Poll T. Endothelial barrier dysfunction in septic shock [J]. J Intern Med, 2015, 277(3): 277-293.
85
Warkentin TE, Aird WC, Rand JH. Platelet-endothelial interactions: sepsis, HIT, and antiphospholipid syndrome [J]. Hematology Am Soc Hematol Educ Program, 2003,1: 497-519.
86
Czabanka M, Peter C, Martin E, et al. Microcirculatory endothelial dysfunction during endotoxemia-insights into pathophysiology, pathologic mechanisms and clinical relevance [J]. Curr Vasc Pharmacol, 2007, 5(4): 266-275.
87
Aird WC. The role of the endothelium in severe sepsis and multiple organ dysfunction syndrome [J]. Blood, 2003, 101(10): 3765-3777.
88
Elzey BD, Sprague DL, Ratliff TL. The emerging role of platelets in adaptive immunity [J]. Cell Immunol, 2005, 238(1): 1-9.
89
Semple JW, Freedman J. Platelets and innate immunity [J]. Cell Mol Life Sci, 2010, 67(4): 499-511.
90
Elzey BD, Schmidt NW, Crist SA, et al. Platelet-derived CD154 enables T-cell priming and protection against Listeria monocytogenes challenge [J]. Blood, 2008, 111(7): 3684-3691.
91
Sprague DL, Elzey BD, Crist SA, et al. Platelet-mediated modulation of adaptive immunity: unique delivery of CD154 signal by platelet-derived membrane vesicles [J]. Blood, 2008, 111(10): 5028-5036.
92
Elzey BD, Tian J, Jensen RJ, et al. Platelet-mediated modulation of adaptive immunity. A communication link between innate and adaptive immune compartments [J]. Immunity, 2003, 19(1): 9-19.
93
Elzey BD, Ratliff TL, Sowa JM, et al. Platelet CD40L at the interface of adaptive immunity [J]. Thromb Res, 2011, 127(3): 180-183.
94
Burnier L, Fontana P, Kwak BR, et al. Cell-derived microparticles in haemostasis and vascular medicine [J]. Thromb Haemost, 2009, 101(3): 439-451.
95
Horstman LL, Ahn YS. Platelet microparticles: a wide-angle perspective [J]. Crit Rev Oncol Hematol, 1999, 30(2): 111-142.
96
Reid VL, Webster NR. Role of microparticles in sepsis [J]. Br J Anaesth, 2012, 109(4): 503-513.
97
Barry OP, Pratico D, Lawson JA, et al. Transcellular activation of platelets and endothelial cells by bioactive lipids in platelet microparticles [J]. J Clin Invest, 1997, 99(9): 2118-2127.
98
Barry OP, Pratico D, Savani RC, et al. Modulation of monocyte-endothelial cell interactions by platelet microparticles [J]. J Clin Invest, 1998, 102(1): 136-144.
99
Nomura S, Imamura A, Okuno M, et al. Platelet-derived microparticles in patients with arteriosclerosis obliterans: enhancement of high shear-induced microparticle generation by cytokines [J]. Thromb Res, 2000, 98(4): 257-268.
100
Forlow SB, McEver RP, Nollert MU. Leukocyte-leukocyte interactions mediated by platelet microparticles under flow [J]. Blood, 2000, 95(4): 1317-1323.
101
Jy W, Mao WW, Horstman L, et al. Platelet microparticles bind, activate and aggregate neutrophils in vitro [J]. Blood Cells Mol Dis, 1995, 21(3): 217-231.
102
Nieuwland R, Berckmans RJ, McGregor S, et al. Cellular origin and procoagulant properties of microparticles in meningococcal sepsis [J]. Blood, 2000, 95(3): 930-935.
103
Semeraro N, Ammollo CT, Semeraro F, et al. Sepsis-associated disseminated intravascular coagulation and thromboembolic disease [J]. Mediterr J Hematol Infect Dis, 2010, 2(3): e2010024.
104
Delabranche X, Boisrame-Helms J, Asfar P, et al. Microparticles are new biomarkers of septic shock-induced disseminated intravascular coagulopathy [J]. Intensive Care Med, 2013, 39(10): 1695-1703.
105
Holme PA, Solum NO, Brosstad F, et al. Microvesicles bind soluble fibrinogen, adhere to immobilized fibrinogen and coaggregate with platelets [J]. Thromb Haemost, 1998, 79(2): 389-394.
106
赵梦龙, 郭凯, 马永刚, 等. 微粒在脓毒症中的作用机制研究 [J]. 临床急诊杂志, 2016, 17(8): 593-596.
107
Zhang Y, Meng H, Ma R, et al. Circulating microparticles, blood cells, and endothelium induce procoagulant activity in sepsis through phosphatidylserine exposure [J]. Shock, 2016, 45(3): 299-307.
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