新生儿毛细血管渗漏综合征

··DOI10.3877/[e-mail]CLS、、、。。、1-6/、、、、、、、、、、、。granulocytecolony-stimulatingfactorG-CSF、granulocytemacrophagecolo-ny-stimulatingfactorGM-CSF7-8。、、。、1．。、、9。200×103900×103。2．。C1r、C1s、C3a、-1、-2、-6、-8interleukin-1-2-6-8IL-1IL-2IL-6IL-8、-αtumornecrosisfactor-αTNF-α、γ-interferongamma、vas-cularendothelialgrowthfactorVEGF-2angiopoietin-2Ang2、B4leukotrieneB4LB410。systemicinflammatoryresponseSIＲ、LB4。、。、、、、、、、、、、、、、、、。“”leakphase。。、。“”post-leakphase。、、、。。、·5275·20137713ChinJCliniciansElectronicEditionJuly12013Vol．7No．13、。。、、、、。。。、。Kubickia11。1.0μl/minIL-6、IL-8、IL-103C3a。8hC3a、、。、。。systemiccapillaryleaksyndromeSCLSSCLSClarkson121960Clarkson13。γ14-15。SCLS13ⅠⅠa≤3g/dl1518g/dl、≤0.5g/dl3.73.2g/dlⅠb≥3g/dl1519g/dl、≥0.5g/dl3.73.1g/dl。Ⅱ。ⅢICU。Ⅳ。、、、、、、、、、、C1。、1．。1。2。。。25%、。。6%hydroxyethystrachHES308mmol/L＞12h、。、、、。20～35ml/kg。3、/。。continuousrenalreplacementtherapyCＲＲT、、。4、、。ulinastatinUTI。5。6。。2．β-terbutaline、theophylline、VEGF、IL-1。。。·6275·20137713ChinJCliniciansElectronicEditionJuly12013Vol．7No．13。3．1①②③＜50mmHg、＜40mmHg、＜20mmHg④/1.0～1.5＞2.0⑤8h＜1ml·kg－1·h－1、⑥。2。2～5mmol/L＞5mmol/LpH＜7.35。3①cen-tralvenouspresserCVP6～10cmH2O。②pulmonarycapillarywedgepressurePCWP、6～12mmHg＞12mmHgPCWP＜15mmHg、＞15mmHg、＞25mmHgXKerley-B、＞35mmHg。③cardiacindexCI2.5～3.5L·min－1·m2－1。1SteinDMScaleaTM．CapillaryleaksyndromeintraumawhatisitandwhataretheconsequencesAdvSurg201246237-253．2MarozNWeinerID．Secondarycapillaryleaksyndromerelatedtopemetrexedexposure．AmJKidneyDis201259582-583．3YabeHYabeMKoikeT．Ｒapidimprovementoflife-threateningcap-illaryleaksyndromeafterstemcelltransplantationbybevacizumab．Blood20101152723-2724．4．．201113708-710．5．．20116849-850．6KaragolBSErdeveOArsanSetal．Statusepilepticusandcapil-laryleaksyndromeinaneonaterelatedtoperinatalhypoxic-ischemicencephalopathy．IndianJPediatr201077439-441．7KaushalMDBoughanKPromisloffＲetal．Granulocytemacrophagecolony-stimulatingfactorinducedlifethreateningcapillaryleaksyn-dromeacasereport．AmJＲespirCritCareMed1852012A4627．8．-．201233334-336．9XieZGhoshCCPatelＲetal．Vascularendothelialhyperpermeabili-tyinducestheclinicalsymptomsofClarksondiseasethesystemiccapillaryleaksyndrome．Blood20121194321-4332．10NagaoYHaradaHYamanakaHetal．Possiblemediatorsforsystem-iccapillaryleaksyndrome．AmJMed2011124e7-e9．11KubickiaＲGrohmannaJSiepebMetal．Earlypredictionofcapil-laryleaksyndromeininfantsaftercardiopulmonarybypass．EurJCar-diothoracSurg201344275-281．12ClarksonBThompsonDHorwithMetal．Cyclicaledemaandshockduetoincreasedcapillarypermeability．AmJMed196029193-216．13DrueyKMGreippPＲ．NarrativeＲeviewClarksondisease-system-iccapillaryleaksyndrome．AnnInternMed201015390-98．doi10.1059/0003-4819-153-2-201007200-00005．14Sion-SaridＲLerman-SagieTBlumkinLetal．Neurologicinvolve-mentinachildwithsystemiccapillaryleaksyndrome．Pediatrics2010125e687-e692．15JuthierFVEnnezatPFornesPetal．Myocardialinvolvementinsys-temiccapillaryleaksyndromefirstdemonstrationbypathologicfind-ings．EuropeanHeartJournalAcuteCardiovascularCare2012248-252．2013-03-06．J/CD．20137135725-5727．·7275·20137713ChinJCliniciansElectronicEditionJuly12013Vol．7No．13