老年脓毒症病人的内分泌应激改变  

Endocrine stress changes in elderly patients with sepsis

作　　者：孙才智[1] 秦海东[1] SUN Caizhi;QIN Haidong(Emergency Department,the Affiliated Nanjing Hospital of Nanjing Medical University(Nanjing First Hospital),Nanjing 210006,China)

机构地区：[1]南京医科大学附属南京医院(南京市第一医院)急诊科,江苏省南京市210006

出　　处：《实用老年医学》2025年第4期347-351,共5页Practical Geriatrics

摘　　要：随着全球老龄化的加速,老年人群的脓毒症发病率和病死率显著上升,已成为严重威胁公共健康的问题。老年病人面对脓毒症时,其内分泌应激反应呈现出明显的年龄相关特征,这些内分泌应激改变不仅影响脓毒症的疾病进程,也给病人的临床管理带来诸多挑战。本综述系统总结了老年脓毒症病人下丘脑-垂体-肾上腺(HPA)轴、下丘脑-垂体-甲状腺(HPT)轴、下丘脑-垂体-性腺(HPG)轴和肾素-血管紧张素-醛固酮系统(RAAS)的变化及其潜在机制,深入分析激素替代治疗所带来的风险与益处,为优化老年脓毒症病人治疗策略提供坚实的理论依据。With the accelerating pace of global aging,the incidence rate and mortality rate of sepsis among the elderly have risen significantly,posing a serious threat to public health.The elderly patients with sepsis exhibit distinct age-related characteristics in their endocrine stress responses,which not only influence the progression of sepsis but also present challenges to clinical management.This review systematically summarizes the dysfunction and underlying mechanisms of hypothalamic-pituitary-adrenal(HPA)axis,hypothalamic-pituitary-thyroid(HPT)axis,hypothalamic-pituitary-gonadal(HPG)axis and renin angiotensin-aldosterone system(RAAS)in the elderly patients with sepsis,and comprehensively analyzes the risks and benefits of hormone replacement therapy,providing a theoretical foundation for optimizing treatment strategies in the elderly patients with sepsis.

关 键 词：老龄化 脓毒症 内分泌系统 

分 类 号：R631[医药卫生—外科学]