4th Department of Internal Medicine, ATTIKON University General Hospital, 1 Rimini St., 12462 Athens, Greece.
Immunotherapy. 2011 Jan;3(1):117-28. doi: 10.2217/imt.10.82.
Despite advances in supportive care of critically ill patients, sepsis remains an important cause of death worldwide. More than 750,000 individuals develop severe sepsis in North America annually, with a mortality rate varying between 35 and 50%. Over recent years, numerous efforts have been committed to understanding the pathophysiology of septic syndrome, as well as attempts to intervene in the inflammatory cascade with the aim of altering the outcome of the syndrome and to improve survival. Not all of these attempts have been successful. Issued guidelines by the International Sepsis Forum have incorporated only the use of corticosteroids, tight glycemic control and the use of recombinant activated protein C as recommendations for the management of the septic patient along with the initial resuscitation and infection-site control measures. These strategies along, with novel attempts of immunomodulation, are thoroughly reviewed in this article.
尽管危重病患者的支持性治疗取得了进展，但败血症仍然是全球范围内重要的死亡原因。每年有超过 75 万人在北美发展为严重败血症，死亡率在 35%至 50%之间。近年来，人们做出了许多努力来了解败血症综合征的病理生理学，以及试图通过干预炎症级联反应来改变综合征的结果并提高生存率。并非所有这些尝试都取得了成功。国际败血症论坛发布的指南仅将皮质类固醇、严格的血糖控制和重组活化蛋白 C 的使用作为败血症患者管理的建议，同时还包括初始复苏和感染部位控制措施。本文对这些策略以及免疫调节的新尝试进行了全面回顾。
