B族维生素在脓毒症治疗中的研究进展  

Research progress on B vitamins in the treatment of sepsis

作　　者：徐琴 李伦刚 杨玉红 曾帆[2] Xu Qin;Li Lungang;Yang Yuhong;Zeng Fan(School of Clinical Medicine,North Sichuan Medical University,Nanchong 637000,Sichuan,China;Department of Intensive Care Unit,Sichuan Provincial People's Hospiatl,Chengdu 610000,Sichuan,China;Department of Intensive Care Unit,Chengdu Shuangnan Hospital,Chengdu 610000,Sichuan,China)

机构地区：[1]川北医学院临床医学院,四川南充637000 [2]四川省人民医院重症医学中心,四川成都610000 [3]成都双楠医院重症医学科,四川成都610000

出　　处：《中华危重病急救医学》2024年第11期1221-1225,共5页Chinese Critical Care Medicine

基　　金：四川省科技厅重点研发项目(2023YFS0134);四川省干部保健普及应用项目(川干研2023-208)。

摘　　要：脓毒症是重症监护病房(ICU)常见的一类急危重症,病死率高,且存活患者往往遗留认知功能损伤。脓毒症的发病机制主要与免疫功能失调及过度氧化应激反应相关,因而免疫调节及抗炎、抗氧化策略是脓毒症治疗的重点。近年来研究发现B族维生素具有调节免疫细胞及抗炎、抗氧化的作用,因而B族维生素治疗脓毒症的功效受到了广泛关注。其中,维生素B2和维生素B9具有调节免疫细胞的作用,发挥免疫调节的功能;维生素B1、B2、B6和B12具有抗炎和抗氧化作用。维生素B1主要通过调节三羧酸循环发挥抗氧化作用,通过调节脓毒症患者体内炎症因子水平发挥抗炎作用,目前已应用于临床。维生素B2的抗炎功能是通过调节脓毒症患者体内的炎症因子及减少巨噬细胞中炎症小体激活来实现的。维生素B6通过清除自由基及增加抗氧化酶的产生来发挥抗炎、抗氧化作用。另外,维生素B1、B6、B9及B14有改善脓毒症患者神经认知功能的效果。本文就B族维生素对免疫功能的调节、抗炎和抗氧化作用、以及B族维生素在脓毒症治疗中的应用进行综述,以期为脓毒症的治疗提供新的途径。Sepsis is a prevalent form of acute and critical illness encountered in intensive care unit(ICU),characterized by a high mortality and cognitive impairments among survivors.The pathogenesis of sepsis primarily involves immune dysfunction and excessive oxidative stress.Consequently,immune modulation,along with anti-inflammatory and antioxidant strategies,has emerged as a focal point in the treatment of sepsis.Recent studies have highlighted the potential of B vitamins to modulate immune cell activity while exhibiting anti-inflammatory and antioxidant properties,thereby garnering significant interest regarding their therapeutic efficacy in sepsis management.Notably,vitamin B2 and vitamin B9 are recognized for their roles in regulating immune cells and facilitating immune modulation.Vitamins B1,B2,B6,and B12 demonstrate notable anti-inflammatory and antioxidant effects.Specifically,vitamin B1 exerts its antioxidant influence through the regulation of the tricarboxylic acid cycle while mitigating inflammation by modulating inflammatory factor levels in septic patients—an application that has been integrated into clinical practice.The anti-inflammatory action of vitamin B2 is achieved through the regulation of inflammatory mediators in septic patients alongside reducing inflammasome activation within macrophages.Vitamin B6 contributes to both anti-inflammatory responses and antioxidative defense by scavenging free radicals and enhancing the production of antioxidant enzymes.Furthermore,vitamins B1,B6,B9,and B14 have shown promise in improving neurocognitive function among individuals suffering from sepsis.This article reviews the immunomodulatory functions as well as the anti-inflammatory and antioxidative effects associated with various B vitamins while exploring their applications within sepsis treatment to propose novel therapeutic avenues.

关 键 词：B族维生素 脓毒症 免疫调节 抗氧化 维生素治疗 

分 类 号：R459.7[医药卫生—急诊医学]