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目前认为流行性出血热(简称出血热)是一种免疫反应性疾病。病原因子和免疫病理损害可引起全身广泛的小血管损伤、微循环障碍及凝血异常。凝血障碍尤其是DIC的发生发展是加重本病出血、休克和肾功能衰竭的中间病理机制。应用抑制血栓形成的抗凝解聚治疗在一定程度上可阻断异常凝血程序,改善微循环灌注,减轻由DIC所致的病理变化而有利于病情缓解,减少并发症,提高越期率及治愈率。但近年来通过对本病出血机理的研究发现其出血机理是多因性的,且随病期不同而异。病程早期出血主要系毛细血管受损伤,血小板减少及功能障碍所致;休克早期以DIC为主,部分病例因类肝素物质增高引起,晚期可发生继发
At present, epidemic hemorrhagic fever (referred to as hemorrhagic fever) is an immunoreactive disease. Pathogenic factors and immunopathological damage can cause a wide range of systemic small vessel damage, microcirculation disorders and coagulation abnormalities. The development of coagulation disorders, especially DIC, is an intermediate pathological mechanism that aggravates bleeding, shock and renal failure. The application of anticoagulation and depolymerization therapy that inhibits thrombosis can block the abnormal coagulation process to a certain extent, improve microcirculation perfusion and relieve the pathological changes caused by DIC, which is beneficial to the remission of the disease, reducing the complications, increasing the overdue rate and curing rate. However, in recent years through the bleeding mechanism of this disease found that bleeding mechanism is multi-cause, and with different stages vary. Early course of bleeding is mainly due to capillary damage, thrombocytopenia and dysfunction; shock in the early DIC-based, in some cases due to increased heparin-like substances, can occur late in the secondary