Ty-jour t1 - Covid-19中的Jak抑制剂：需要警惕固有的血栓性风险JF - 欧洲呼吸期刊Jo - Eur Respir J Do - 10.1183 / 13993003.01919-2020 SP - 2001919 Au - Mehta，Puja Au - Ciurtin，CozianaAu - Scully，Marie Au - Levi，Marcel Au - Chambers，Rachel C. Y1 - 2020/01/01/01 UR - //www.qdcxjkg.com/content/early/2020/07/02/13993003.01919-2020摘要N2 - 积累的证据是Covid-19是高凝状态。Covid-19患者肺血栓形成微盲病的血栓形成事件和尸检发现的报告升高。Bompard等人。最近报告了137例Covid-19肺炎患者的队列研究，其中对计算断层扫描肺血管造影（CTPA）扫描的回顾性审查证明了24％总体肺栓塞（PE）的累积发病率，重症监护了50％[2]。虽然最初认为阴沉的静脉血栓栓塞事件（VTE）主要被局限于通风患者[3]，我们现在了解Covid-19中的血栓性风险是更广泛的问题。在患有严重Covid-19的选定患者中过度膨胀的宿主炎症反应可能导致高死亡率。我们最近推荐用于在Covid-19中的病毒驱动的高炎性筛查，并提出在该患者的免疫调节，可能改善结果[4]。有几种正在进行的随机对照试验，评估严重Covid-19中Janus激酶抑制剂（JAKI）的治疗潜力（表1）。Jaki在Covid-19中的其他免疫调节策略中有一个声称的优势，因为它们可以施加双重抗炎（同时封闭多种，促炎细胞因子）和抗病毒效应（阻碍细胞病毒内吞作用[5,6]）和 have convenient oral administration, with relatively short half-lives. JAKi may interrupt the signalling of several pro-inflammatory cytokines implicated in the pathogenesis of hyperinflammation, including interleukin (IL)-6, which has been the focus of several clinical trials in COVID-19. JAKi may also inhibit the entry of the SARS-CoV-2 virus into the AT2 alveolar epithelial cells; baricitinib (a JAK1/2 inhibitor), is a numb-associated kinase (NAK) inhibitor, with a particularly high affinity for AP2-associated protein kinase 1 (AAK1), a pivotal regulator of clathrin-mediated viral endocytosis [5]. We recommend vigilance to the potentially increased thrombotic risk associated with JAKi, given the hypercoagulability of COVID-19 and our recent thromboprophylaxis recommendations for all hospitalised patients with COVID-19 [7]. ER -