脓毒症的病原及免疫特征:从分子机制到临床治疗的研究进展  

Etiological and immune characteristics of sepsis: from molecular mechanisms to clinical treatment

作　　者：陶诗萌 路倩 曹炬[1] Tao Shimeng;Lu Qian;Cao Ju(Department of Laboratory Medicine,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400042,China)

机构地区：[1]重庆医科大学附属第一医院检验科,重庆400042

出　　处：《中华微生物学和免疫学杂志》2025年第3期205-213,共9页Chinese Journal of Microbiology and Immunology

基　　金：国家自然科学基金(82370009);国家重点研发计划(2023YFC2412900);重庆市自然科学基金(CSTB2022NSCQ-LZX0017);重庆市医学科研项目(重庆市卫生健康委员会与科技局联合项目)(2024ZDXM002)。

摘　　要：2016年发布的脓毒症最新定义(Sepsis 3.0)将脓毒症重新定义为由感染引起的反应失调性免疫综合征,进而导致危及生命的器官功能障碍,并引入序贯器官衰竭评分(sequential organ failure assessment,SOFA)作为其诊断的关键指标之一,使得脓毒症的诊断更为精准且便于临床应用。尽管目前在脓毒症的诊治方面有显著进展,但高发病率、高病死率和高医疗成本依旧是全球公共卫生的重大挑战。脓毒症的核心发病机制涉及宿主免疫应答的严重失调,并进一步引发组织损伤和多器官功能障碍。因此,深入研究脓毒症的免疫应答机制对优化临床治疗策略至关重要。本文系统地总结了脓毒症的病原微生物特征、发病机制、各阶段的免疫特征和临床治疗面临的挑战,并探讨了精准医疗在脓毒症临床诊疗中的潜在价值,旨在为解决脓毒症多重耐药性和免疫机制研究方面的关键问题提供参考。Sepsis was redefined in 2016 by the updated Sepsis 3.0 criteria as a life-threatening organ dysfunction caused by dysregulated immune response to infection.This revision introduced the sequential organ failure assessment(SOFA)score as one of the key diagnostic criteria,making the diagnosis of sepsis more precise and clinically applicable.Despite significant advancements in the diagnosis and treatment of sepsis,its high incidence,mortality rate,and healthcare costs remain major global public health challenges.The core pathogenesis of sepsis involves severe dysregulation of the host immune response,which further leads to tissue damage and multiple organ dysfunction.Therefore,in-depth research into the immune response mechanisms of sepsis is crucial for optimizing clinical treatment strategies.This article systematically summarizes the characteristics of pathogenic microorganisms in sepsis,its pathogenesis,immune features at various stages,and the challenges faced in clinical treatment.It also explores the potential value of precision medicine in the clinical diagnosis and treatment of sepsis,aiming to provide references for addressing key issues in multidrug resistance and immune mechanism research in sepsis.

关 键 词：脓毒症 免疫抑制 免疫治疗 

分 类 号：R459.7[医药卫生—急诊医学]