脓毒症相关性脑病诊断及病理生理机制研究进展  

Diagnosis and pathophysiology of septic-associated encephalopathy

作　　者：李项瑞 阴弯弯 黄怡 侯立朝 

机构地区：[1]第四军医大学第一附属医院麻醉科,西安710032

出　　处：《国际麻醉学与复苏杂志》2017年第4期360-363,373,共5页International Journal of Anesthesiology and Resuscitation

基　　金：国家自然科学基金（81171839）;中国博士后基金（2013M532156）

摘　　要：背景脓毒症相关性脑病（sepsis-associated encephalopathy，SAE）是脓毒症常见但发病机制不明确的神经系统并发症，其临床表现从轻度的不适感和注意力不集中到重度的昏迷。SAE的发生与脓毒症高病死率和远期并发症密切相关。目的对SAE的诊断、病理生理机制和治疗进行综述。内容阐述与SAE诊断相关的实验室检查、生物学标记物、病理生理机制，如神经递质和氨基酸紊乱，脑灌注和微循环改变，炎性反应和氧化应激损伤以及临床治疗。趋向SAE无特效的治疗方法，仅有原发病治疗和对症支持治疗。应该根据SAE的病理生理机制选择可能控制紊乱通路的药物治疗而不仅仅是控制患者症状。Background Sepsis-associated encephalopathy（SAE） is a common neurologic complications of sepsis. Its clinical manifestation includes the alternations in mental status, ranging from discomfort and disorientation to deep coma. With the development of SAE, it comes increased mortality and incidence of long-term complications of sepsis. But the pathophysiology specific to SAE is poorly understood. Objective To make a elaboration and a further understanding of the diagnosis, pathophysiology and treatment of SAE. Content The options of assistant examinations and biomarkers to diagnose SAE are discussed together with that disorders of neurotransmitters and amino acids, changes of cerebral blood flow and microcirculation, inflammation and oxidative stress of the pathophysiology of SAE as well as clinical treatment. Trend Currently available treatments for SAE focus on controlling original infection and alleviating neurological symptoms, and need to be improved by fresher basic and translational research.

关 键 词：脓毒症 脓毒症相关性脑病 神经炎症 

分 类 号：R459.7[医药卫生—急诊医学] R747.9[医药卫生—治疗学]