Fraunberger P, Drexel H, Walli A K
Medizinisches Zentrallabor, Feldkirch, Österreich.
Dtsch Med Wochenschr. 2010 Oct;135(43):2128-32. doi: 10.1055/s-0030-1267491. Epub 2010 Oct 19.
Severe sepsis and septic shock are common complications in the intensive care unit and associated with high mortality. Early antimicrobial therapies together with organ-supportive measures are the major therapeutic approaches. However in the last decades immunomodulatory therapies have been investigated due to the notion of a compromised inflammatory response in septic patients. In addition to lowering circulating cholesterol, statins (HMG-CoA-reductase-inhibitors) have also been shown to possess pleiotropic anti-inflammatory potential. Recent studies indicate that these anti-inflammatory effects also modulate acute inflammatory response and therefore may play a protective role in septic patients. In this review, the pathophysiological background and first clinical trials of statins as a new adjuvant therapy in sepsis are summarized.
严重脓毒症和脓毒性休克是重症监护病房常见的并发症，且死亡率很高。早期抗菌治疗联合器官支持措施是主要的治疗方法。然而，在过去几十年中，由于脓毒症患者存在炎症反应受损的观念，免疫调节疗法受到了研究。除了降低循环胆固醇外，他汀类药物（HMG-CoA还原酶抑制剂）还被证明具有多效抗炎潜力。最近的研究表明，这些抗炎作用还可调节急性炎症反应，因此可能在脓毒症患者中发挥保护作用。在本综述中，总结了他汀类药物作为脓毒症新辅助治疗的病理生理背景和首批临床试验情况。
