Laboratory of Anesthesiology, Department of Anesthesiology and Critical Care Medicine, Lariboisière Hospital, APHP, University of Paris 7 Diderot, Paris, France.
Minerva Anestesiol. 2010 Sep;76(9):737-43.
Downregulation of the immune response is common among Intensive Care Unit (ICU) patients after an acute inflammatory injury, whether it was septic or not. Such a modification could be seen as an adaptation to attenuate the effects of the inflammatory storm on tissues, but it exposes the subject to the risk of nosocomial infection and impairs recovery processes. The intensity of immunity downregulation is difficult to characterize, since clinical presentation is silent and non-specific, which urges the use of tools for immune monitoring. This review focuses on the use of monocyte HLA-DR expression to detect immune hyporesponsiveness and to select the appropriate immunomodulating therapy, as well as the efficiency of this technique in controlling secondary infections.
在急性炎症损伤后，无论是脓毒症还是其他情况，重症监护病房（ICU）患者的免疫反应通常会受到抑制。这种调节可以被视为一种适应机制，以减轻炎症风暴对组织的影响，但也使患者面临医院感染的风险，并影响恢复过程。免疫抑制的强度难以确定，因为临床表现是隐匿和非特异性的，这促使我们使用免疫监测工具。本文重点介绍了使用单核细胞 HLA-DR 表达来检测免疫低反应性并选择适当的免疫调节治疗，以及该技术在控制继发感染方面的效果。
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