外泌体在老年脓毒症中的研究进展——聚焦老年病人的病理生理特征与临床挑战  

Research progress of exosomes in elderly patients with sepsis:focus on the pathopathological characteristics and clinical challenges in the elderly

作　　者：左睿 顾双双[2] 王军[1,2] ZUO Rui;GU Shuangshuang;WANG Jun(Emergency Department,Nanjing Drum Tower Hospital Clinical College of Nanjing Medical University,Nanjing 210008,China;Emergency Department,Nanjing Drum Tower Hospital Affiliated to Medical School of Nanjing University,Nanjing 210008,China)

机构地区：[1]南京医科大学鼓楼临床医学院急诊科,江苏省南京市210008 [2]南京大学医学院附属鼓楼医院急诊科,江苏省南京市210008

出　　处：《实用老年医学》2025年第4期330-335,340,共7页Practical Geriatrics

基　　金：江苏省干部保健科研课题(BJ23031);南京市卫生科技发展专项资金项目-医学重点科技发展项目(zkx24011);南京市医学科技发展一般项目(YKK23066)。

摘　　要：脓毒症是全球急危重症医学领域内的一项重大临床挑战,在老龄化社会背景下,其高发病率与病死率问题显得尤为严峻。老年人群因对脓毒症更易感、合并症多,极大地加剧了不良预后的风险,给社会带来了沉重的经济负担。因此,聚焦老年脓毒症病人的病理生理及临床挑战、开展早期诊断及治疗意义重大。在脓毒症相关免疫失调、内皮屏障破坏及器官损伤中,外泌体作为细胞间通信的媒介发挥调控作用,同时具备作为新型诊断生物标志物与靶向治疗载体的双重潜力。本综述阐述了老年脓毒症病人的病理生理及临床特征,以及外泌体在老年脓毒症发生发展与转归中扮演的角色及临床诊治前景,以期为突破当前老年脓毒症精准医学困境提供一定的理论参考。Sepsis remains a formidable clinical challenge in the field of critical care medicine worldwide,particularly exacerbated by the aging population due to high incidence and mortality rates.Elderly patients exhibit heightened susceptibility to sepsis and more multiple comorbidities,which synergistically amplify risks of adverse outcomes and impose substantial economic strain on healthcare systems.Therefore,focusing on the pathophysiological mechanisms and clinical complexities specific to sepsis in the elderly,implementing early diagnosis and targeted interventions have important value.The exosomes play the regulatory role as intercellular communicators in sepsis-associated immune dysregulation,endothelial barrier disruption and multi-organ injury.These nanovesicles demonstrate dual potential as both novel diagnostic biomarkers and precision therapeutic vehicles for targeted drug delivery.This article reviews the distinctive pathophysiological and clinical characteristics of sepsis in the elderly patients,systematically elaborates the roles of exosomes in disease progression and clinical outcomes,and explores the promising diagnostic and therapeutic applications of exosome-based strategies,which can provide theoretical foundation to overcome current challenges in precision medicine for sepsis in the elderly.

关 键 词：脓毒症 老年人 外泌体 生物标志物 诊断与治疗 

分 类 号：R631[医药卫生—外科学]