外科脓毒症免疫功能障碍的监测与调理策略  

Immune dysfunction in the development of sepsis： from monitoring of immune status to immunomodulatory strategy

作　　者：姚咏明[1] 栾樱译[1] 

机构地区：[1]解放军总医院第一附属医院全军烧伤研究所,北京100048

出　　处：《中华消化外科杂志》2014年第7期516-519,共4页Chinese Journal of Digestive Surgery

基　　金：国家自然科学基金（81130035、81372054、81121004）;国家重点基础研究发展计划（973计划）项目（2012CB518102）;军队“十二五”计划重大项目（AWS11J008、BWS12J050）

摘　　要：脓毒症是一种严重的感染并发症,通常是由微生物感染、严重烧（创）伤及外科大手术对机体应激打击等引发,并伴有全身炎症反应综合征和MODS,从而导致在ICU中的高发病率及病死率.长期以来,由于临床医师对于外科打击后机体免疫功能障碍的确切机制及其在脓毒症中的作用认识不足,临床上缺乏切实有效的免疫功能监测手段和调理措施.近年来随着对脓毒症发病本质的逐步了解,临床医师已认识到脓毒症发病机制非常复杂,除感染与炎症过程外,机体免疫功能障碍参与了脓毒症的病理生理过程,且发挥关键作用.因此,对烧（创）伤、外科大手术后脓毒症机体免疫状况的合理监测,寻求新的有效防治途径,对于严重脓毒症的早期识别、诊断和干预,降低重症患者病死率及提高患者生命质量具有重大意义.Sepsis is a severe complication which is usually caused by microbial infection,severe burns or trauma and major operations.Patients with sepsis were usually complicated with systemic inflammatory response and multi-organ dysfunction syndrome,which is the leading cause of death in the intensive care units.However,the main immunoregulatory mechanisms underlying severe sepsis remain unclear,and effective methods for monitoring immune status and immunomodulatory strategies need to be investigated.In recent years,the understanding of the mechanism of sepsis has been developed.Clinicians have learned that immune dysfunction took part in the pathophysiological process of sepsis.Therefore,rational monitoring of immune status in patients with severe sepsis after burns or major operation,seeking effective ways for diagnosis,treatment and intervention are of great significance in decreasing the mortality and improving the life quality.

关 键 词：脓毒症 免疫功能 监测 免疫调理 

分 类 号：R459.7[医药卫生—急诊医学]