脓毒症致多脏器功能损伤机制的临床研究进展  

Clinical Research Progress on the Mechanism of Multiple Organ Damage Caused by Sepsis

作　　者：刘妍(综述) 李倩(审校)[1] Liu Yan;Li Qian(Department of Emergency Medicine,Yijishan Hospital of Wannan Medical College,Wuhu 241001 China)

机构地区：[1]皖南医学院附属弋矶山医院急诊内科,安徽芜湖241001

出　　处：《锦州医科大学学报》2020年第4期108-112,共5页Journal of Jinzhou Medical University

摘　　要：普遍认为脓毒症是由严重感染引起的全身性炎症反应综合征(systemic inflammatory response syndrome,SIRS)。特别是在多器官功能损伤的情况下,高死亡率一直是社会医学界密切关注的话题。脓毒症导致不同的器官功能损伤的致病机制,合并肺损伤时主要受氧化应激和炎症因子的影响;结合由于炎症介质作用于血管系统而导致的肾功能不全,导致肾毛细血管损害,微循环障碍,肾小球滤过率明显降低;合并脑功能损伤的主要原因是血脑屏障受损,神经递质紊乱,多种代谢信号通路被阻断;合并胃肠功能损伤者更多是由脓毒症应激引起的胃肠粘膜屏障破坏,细菌移位,胃肠激素紊乱引起的;脓毒症的大量炎性介质诱导心肌细胞凋亡,破坏心肌线粒体氧化,引起心力衰竭的代谢过程。因此探索脓毒症致多脏器功能损伤的错综复杂发病机理,对改善脓毒症的目前临床治疗现状意义重大。Sepsis is generally considered to be a systemic inflammatory response syndrome(SIRS)caused by a severe infection.Especially in the case of multiple organ damage,high mortality has been a topic of close concern in the social medical community.Sepsis leads to different pathogenic mechanisms of organ damage.Combined with lung injury,it is mainly affected by oxidative stress and inflammatory factors.Combined with renal insufficiency caused by inflammatory mediators acting on the vascular system that leads to renal capillary damage,and microcirculation disorders,glomerular filtration rate is significantly reduced.The main causes of combined brain function damage are impaired blood-brain barrier,neurotransmitter disorders,and blocked multiple metabolic signaling pathways.Those with combined gastrointestinal damage are more likely to have gastrointestinal mucosal barrier damage,bacterial translocation,and gastrointestinal hormone disorders,which are due to sepsis stress.A large number of inflammatory mediators of sepsis induce myocardial cell apoptosis,destroy myocardial mitochondrial oxidation,and cause metabolic processes of heart failure.Therefore,exploring the complicated pathogenesis of multiple organ damage caused by sepsis is of great significance for improving the current clinical treatment status of sepsis.

关 键 词：脓毒症 多脏器功能损伤 致病机制 

分 类 号：R631[医药卫生—外科学]