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机构地区:[1]徐州医科大学附属连云港医院(连云港市第一人民医院)重症医学科,江苏连云港222002
出 处:《临床急诊杂志》2017年第9期713-718,共6页Journal of Clinical Emergency
基 金:基金项目:江苏省连云港市科技局重症医学学科(平台)建设(No:SH1601)
摘 要:脓毒症与脓毒症休克定义国际共识(2014年修订,第3版)将脓毒症(sepsis)定义更新为机体对感染的反应失调而导致危及生命的器官功能障碍[1],以往关于脓毒症的定义过于强调感染,现在以机体对感染的反应失调和器官功能障碍为核心。Although antibiotics, ventilator management, liquid recovery strategies and blood glucose control have been widely used in treatment of sepsis,septic shock is still the major cause of death in the intensive care unit (ICU). In USA,medical and nursing expenses associated with sepsis were estimated at $17 billion per year and it was still rising. The immune dysfunction is the major cause of death in patients with sepsis shock. The excessive activation of inflammatory response and the subsequent suppression of immune function can cause severe damage to multiple systemic organ functions including the cardiovascular system, respiratory system, urinary system, etc. This paper summarizes the possible causes and mechanisms of sepsis immune paralysis, the possible pathways of pro- grammed death-1 (PD-1,CD279),T cell immunoglobulin and mucin domain-3 (Tim-3 or HAVCR2),cytotoxic T lymphocyte-associated antigen-4 (CTLA-4,CD152) mediated T-cell immunosuppression, the research direction of negative costimulatory molecules in immunomodulation therapy of sepsis is also prospected.
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