Department of Internal Medicine, St. Antonius Hospital, Nieuwegein, The Netherlands.
J Intern Med. 2012 Jul;272(1):25-35. doi: 10.1111/j.1365-2796.2012.02554.x.
Pneumonia exhibits a broad range of severity, from mildly symptomatic at one end to fulminant septic shock and death at the other. Although an adequate inflammatory response is necessary for the clearance of microorganisms, excessive inflammation can lead to ongoing local and systemic damage. Because of this extended inflammatory response despite appropriate antibiotic therapy, as well as increasing antibiotic resistance, adjuvant therapy for pneumonia that can favourably modify the immune response has become an increasingly relevant approach to improve prognosis. Different adjuvant treatment options for pneumonia have recently been proposed. Promising treatment options include corticosteroids, statins, macrolides and Toll-like receptor antagonists. The aim of this review is to summarize the inflammatory response during pneumonia and discuss the current knowledge and future perspectives regarding the anti-inflammatory treatment options for patients with pneumonia.
肺炎的严重程度差异很大,从一端的轻度症状到另一端的暴发性败血性休克和死亡。虽然适当的炎症反应对于清除微生物是必要的,但过度的炎症会导致持续的局部和全身损伤。由于这种持续的炎症反应尽管使用了适当的抗生素治疗,以及抗生素耐药性的增加,因此针对肺炎的辅助治疗可以改善免疫反应,已成为改善预后的一种越来越重要的方法。最近提出了不同的肺炎辅助治疗方案。有前途的治疗方案包括皮质类固醇、他汀类药物、大环内酯类药物和 Toll 样受体拮抗剂。本综述旨在总结肺炎过程中的炎症反应,并讨论关于肺炎患者抗炎治疗方案的现有知识和未来展望。