Ty -jour t1 -covid -19中的jak抑制剂：需要警惕固有的血栓形成风险JF -Europen呼吸杂志JO -EUR RESSIR J DO -10.1183/13993003.01919-2020 SP -2001919 AU -MEHTA -MEHTA，PUJA AU -CIURTIN，COZIARTIN，COZIANA，COZIANA，Au -Scully，Marie Au -Levi，Marcel Au -Chambers，Rachel C. Y1-2020/01/01 Ur -http：//www.qdcxjkg.com/content.com/content/content/early/early/2020/07/02/02/02/02/13993003.0191919-2020。摘要N2-有积累的证据表明Covid -19是一种超凝状态。COVID-19患者的血栓性事件和肺血栓形成微动病[1]的尸检结果正在增加。Bompard等。最近报道了一项对137例CoVID-19-19肺炎患者的队列研究，其中对计算机断层扫描肺血管造影（CTPA）扫描的回顾性回顾表明，肺栓塞（PE）的累积发生率为24％，在强化护理中为50％[2] [2]。尽管最初认为阴险的静脉血栓栓塞事件（VTE）主要局限于通风患者[3]，但我们现在了解血栓形成风险是在Covid-19中成为更广泛的问题。在某些严重的COVID-19患者中，过度活跃的宿主炎症反应可能导致高死亡率。我们最近建议在Covid-19中筛查病毒驱动的高炎症，并提出在这一患者亚组中的免疫调节可能会改善预后[4]。有几项正在进行的，随机的对照试验评估了严重的Covid-19中Janus激酶抑制剂（JAKI）的治疗潜力（表1）。Jaki在Covid-19中具有比其他免疫调节策略具有优势，因为它们可能发挥双重抗炎（封闭多种，促炎性细胞因子）和抗病毒作用（障碍细胞病毒内吞作用[5，6]）和抗病毒作用 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 -