重症新型冠状病毒感染患者免疫病理机制及免疫治疗的研究进展  

Progress of immunopathology and immunotherapy in patients with severe coronavirus disease 2019

作　　者：高军龙 甘亮亮 郭龙飞 袁媛[1] Gao Junlong;Gan Liangliang;Guo Longfei;Yuan Yuan(Department of Emergency of Critical Care Medicine,Gansu Provincial Hospital,Lanzhou 730000,Gansu,China)

机构地区：[1]甘肃省人民医院急诊重症医学科,甘肃兰州730000

出　　处：《中国中西医结合急救杂志》2023年第3期375-380,共6页Chinese Journal of Integrated Traditional and Western Medicine in Intensive and Critical Care

基　　金：甘肃省兰州市科技计划项目(2022-5-62)。

摘　　要：新型冠状病毒感染(COVID-19)出现以来,全球相关学者投入巨大精力研究其致病原理,重症免疫机制得到进一步阐述,为合理的治疗提供了理论支持。COVID-19重症免疫机制较为复杂,主要涉及先天性免疫反应中干扰素(IFN)诱导缺陷、中性粒细胞活化、单核/巨噬细胞肺部过度浸润、树突状细胞和自然杀伤细胞(NK细胞)功能障碍、补体系统过度激活以及细胞因子风暴形成;适应性免疫反应中B细胞抗体成熟延迟,T细胞反应延迟和亚群失衡。目前COVID-19免疫治疗可能有效的措施主要有恢复期血浆、中和性单克隆抗体、皮质类固醇、白细胞介素-1(IL-1)抑制剂、IL-6抑制剂、IFN抑制剂、Janus激酶(JAK)抑制剂、补体C3和C5抑制剂、氟伏沙明、胸腺肽α1等,但上述方案也有一定局限性,甚至出现不良临床结局。因此COVID-19重症免疫机制以及免疫治疗措施需要进一步研究。Since the outbreak of coronavirus disease 2019(COVID-19),relevant scholars around the world have invested great efforts in studying the pathogenesis of COVID-19.The mechanism of the immune disorders of critical cases is further elucidated,providing tmplement system,and formation of cytokine storm;and adaptive immunity,such as delay in B cell antibody maturation,delay in T cell response and subset alteration of T cell.Currently,effective measures for COVID-19 immunotherheoretical support for adequate treatment.Current researches show that the immune mechanism of severe COVID-19 is complex,mainly involving innate immunity,such as defects in interferon(IFN)induction,activation of neutrophils,excessive lung perfusion of mononuclear phagocytes,dysfunction of dendritic cells and natural killer cells,overactivation of the coapy include convalescent plasma,neutralizing monoclonal antibodies,corticosteroids interleukin-1(IL-1)inhibitors,IL-6 inhibitors,IFN preparations,Janus kinase(JAK)inhibitors,complement C3 and C5 inhibitors,fluvoxamine,thymosin alpha 1,etc.However,these approaches also have certain limitations and even adverse clinical outcomes.Therefore,the immune mechanism and immunotherapeutic measures of severe COVID-19 need to be further studied.

关 键 词：新冠肺炎 免疫机制 免疫治疗 

分 类 号：R246.1[医药卫生—针灸推拿学]