Эндотелиальная дисфункция при травме: патогенез, клиническое значение, диагностика и лечение

Тяжелая травма представляет собой важнейшую медицинскую и социальную проблему. Тяжелые повреждения являются главной причиной гибели людей в возрасте до 44 лет. Многие выжившие после травмы становятся инвалидами. Если не учитывать немедленную смерть пострадавших на догоспитальном этапе, внутрибольничная летальность, как правило, обусловлена геморрагическим шоком, коагулопатией, системным воспалением, как инфекционной, так и неинфекционной природы, и полиорганной недостаточностью.

В последнее десятилетие признается значительная роль эндотелиальной дисфункции в развитии данных патологических процессов. Под эндотелиальной дисфункцией понимают чрезмерную активацию эндотелия, сопровождающуюся мультисистемными проявлениями. В данном обзоре литературы представлены современные данные о физиологии нормального эндотелия, патогенезе развития эндотелиальной дисфункции при травме, о ее роли в развитии системного воспаления, повышения сосудистой проницаемости и коагулопатии, о методах ее диагностики и коррекции.

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