脓毒症相关性谵妄与神经内分泌免疫调控紊乱  

Sepsis-associated delirium and disorder of neuroendocrine immune regulation

作　　者：刘艾昕 孙聪俐 亢晓敏 刘莉洁[1,2] LIU Aixin;SUN Congli;KANG Xiaomin;LIU Lijie(Southeast University Medicine School,Nanjing 210009,China;Jiangsu Provincial Key Laboratory of Critical Care Medicine,Nanjing 210009,China)

机构地区：[1]东南大学医学院,南京210009 [2]江苏省重症医学重点实验室,南京210009

出　　处：《中国免疫学杂志》2025年第2期467-471,共5页Chinese Journal of Immunology

基　　金：国家自然科学基金(81970893,82171541);江苏省重症医学重点实验室自主课题(JSKLCCM-2022-02-002)。

摘　　要：脓毒症相关性谵妄(SAD)是脓毒症患者的一种常见严重中枢神经系统(CNS)并发症,目前发生机制未明,尚无有效治疗措施。神经内分泌免疫调控紊乱与SAD发生发展密不可分。免疫介质可借助体液运输或通过传入神经将外周免疫信息传递至CNS,入侵中枢的免疫介质不仅可直接损伤神经元,还将激活脑的固有免疫细胞,进一步加重神经炎症,并引起神经递质失衡,引发神经毒性效应,导致神经元功能障碍甚至凋亡及随后的行为和认知症状。本文旨在对神经内分泌免疫调控在SAD发生发展中的调控机制进行综述,为脓毒血症及SAD寻找有效防治靶点。Sepsis-associated delirium(SAD)is a common and severe central nervous system(CNS)complication in patients with sepsis,whose occurrence mechanism is unclear and there is no effective treatment at present.Neuroendocrine immune regulation disorder is closely related to occurrence and development of SAD.Immune mediators can deliver peripheral immune information to CNS by humoral transport or through afferent nerves.Immune mediators invading center can not only directly damage neurons,but also activate innate immune cells of brain,further aggravate neuroinflammation,and cause neurotransmitter imbalance,neurotoxic effects,resulting in neuronal dysfunction,even apoptosis and subsequent behavioral and cognitive symptoms.This paper aims to review mechanisms of neuro-endocrine-immune regulation in occurrence and development of SAD,and to find effective targets for prevention and treatment of sepsis and SAD.

关 键 词：脓毒症相关性谵妄 神经-内分泌-免疫调控网络 神经炎症 炎症因子 

分 类 号：R392[医药卫生—免疫学]