脓毒症免疫抑制诊治专家共识  

Chinese expert consensus on diagnosis and management of immunosuppression in sepsis

作　　者：中国研究型医院学会休克与脓毒症专业委员会 中国人民解放军重症医学专业委员会 重症免疫研究协作组 吴健锋[2] 栾樱译[3] 柯路 姚咏明 李维勤 管向东 Shock and Sepsis Society of the Chinese Research Hospital Association;Critical Care Medicine Society of the Chinese People's Liberation Army(PLA);Critical Care Immunotherapy Research Group;Wu Jianfeng;Luan Yingyi;Ke Lu(不详;The First Affiliated Hospital of Sun Yat-sen University,Guangzhou 510010,Guangdong,China;The Fourth Medical Center and Medical Innovation Research Division of the Chinese PLA General Hospital,Beijing 100048,China;General Hospital of Eastern Theater Command,Nanjing 210002,Jiangsu,China)

机构地区：[1]不详 [2]中山大学附属第一医院,广东广州510010 [3]解放军总医院第四医学中心、医学创新研究部,北京100048 [4]解放军东部战区总医院,江苏南京210002

出　　处：《中华危重病急救医学》2020年第11期1281-1289,共9页Chinese Critical Care Medicine

基　　金：国家自然科学基金重点项目(81730057);军事医学创新工程重点项目(18CXZ026,BLJ18J006);国家重点研发计划项目(2017YFC1103302)。

摘　　要：本专家共识通过临床研究证据从天然免疫和获得性免疫两个方面阐述了脓毒症免疫障碍机制、监测评估以及免疫增强的药物治疗,旨在帮助临床医生更深入地认识脓毒症诱导的免疫抑制状态及其临床意义。临床资料提示,机体免疫功能紊乱参与了脓毒症的发生与发展过程;单核细胞人类白细胞抗原DR定量检测、淋巴细胞计数可作为反映脓毒症患者天然免疫、获得性免疫功能障碍的重要指标;免疫增强治疗包括增强天然免疫的药物、提高获得性免疫的药物和免疫增强联合抗炎治疗等措施。This expert consensus uses clinical research evidence to explain the mechanism,monitoring and evaluation of sepsis-induced immunosuppression,and treatment with immune stimulation from two aspects:innate immunity and acquired immunity,aiming to help clinicians better understand sepsis-induced immune depression and its clinical significance.Clinical data suggest that the immune dysfunction is critically involved in the occurrence and development of sepsis.Quantitative detection of monocyte human leukocyte antigen DR and lymphocyte count can be used as important indicators to reflect the innate immune and acquired immune dysfunction in patients with sepsis.Immunomodulation therapy includes medication to improve innate immunity and acquired immunity,and immune stimulation combined with anti-inflammatory response.

关 键 词：脓毒症 免疫抑制 免疫功能监测 免疫调理 

分 类 号：R459.7[医药卫生—急诊医学]