Koerner P, Westerholt A, Kessler W, Traeger T, Maier S, Heidecke C-D
Klinik und Poliklinik für Chirurgie, Abteilung für Allgemein-, Viszeral-, Thorax- und Gefässchirurgie, Universitätsklinikum Greifswald, Greifswald, Germany.
Chirurg. 2008 Apr;79(4):290-4. doi: 10.1007/s00104-008-1465-2.
Abdominal surgery is regularly followed by immune dysfunction that can last for several days. In case of septic complications during this period, there is imminent danger of mortality due to reduced immune function. This fact leads to classification of sepsis in regard to its genesis: spontaneously acquired sepsis type A is distinguishable from sepsis type B, which is acquired postoperatively. The main difference between these types is the immunologic condition at the time point of sepsis development. Postoperative immune dysfunction can be described by several parameters, i.e. reduction of HLA-DR expression on monocytes and increased apoptosis of T lymphocytes. A direct correlation exists between magnitude of immune dysfunction and complexity of the previous surgical trauma. For the first time it is now possible to study this phenomenon of postoperative immune dysfunction by use of an adequate animal model. Intestinal manipulation in mice fulfils the necessary criteria to serve as a model of surgically induced immune dysfunction.
腹部手术后常伴有免疫功能障碍,这种障碍可持续数天。在此期间若发生脓毒症并发症,由于免疫功能降低,患者面临着死亡的紧迫危险。这一事实导致脓毒症根据其发生原因进行分类:自发性获得性A 型脓毒症与术后获得性B 型脓毒症有所不同。这些类型之间的主要区别在于脓毒症发生时的免疫状况。术后免疫功能障碍可用几个参数来描述,即单核细胞上 HLA-DR 表达的降低和 T 淋巴细胞凋亡的增加。免疫功能障碍的程度与先前手术创伤的复杂性之间存在直接关联。现在首次有可能通过使用适当的动物模型来研究这种术后免疫功能障碍现象。小鼠的肠道操作符合作为手术诱导免疫功能障碍模型的必要标准。