Department of Surgery, University of Alabama at Birmingham, Birmingham, AL 35294, USA.
J Anesth. 2012 Dec;26(6):883-91. doi: 10.1007/s00540-012-1425-3. Epub 2012 Jun 23.
Although several clinical studies show a gender dimorphism of immune and organ responsiveness in the susceptibility to and morbidity from shock, trauma, and sepsis, there are conflicting reports on the role of gender in outcomes. In contrast, results obtained from experimental studies clearly support the suggestion that gender plays a significant role in post-injury pathogenesis. Studies performed in a rodent model of trauma-hemorrhage have confirmed that alterations in immune and organ functions after trauma-hemorrhage are more markedly depressed in adult males and in ovariectomized and aged females; however, both are maintained in castrated males and in proestrus females. Moreover, the survival rate of proestrus females subjected to sepsis after trauma-hemorrhage is significantly higher than in age-matched males or ovariectomized females. In this respect, organ functions and immune responses are depressed in males with sepsis or trauma, whereas they are unchanged or are enhanced in females. This article reviews studies delineating the mechanism by which estrogen regulates cerebral nervous, lung, and heart systems in an experimental model of sepsis, trauma, or reperfusion injury.
尽管有几项临床研究表明，在对休克、创伤和败血症的易感性以及发病率方面，免疫和器官反应存在性别二态性，但关于性别在结局中的作用存在相互矛盾的报告。相比之下，来自实验研究的结果清楚地表明，性别在受伤后的发病机制中起着重要作用。在创伤-出血的啮齿动物模型中进行的研究证实，创伤-出血后免疫和器官功能的改变在成年雄性和去卵巢及老年雌性中更为明显抑制；然而，在去势雄性和发情前期雌性中则得到维持。此外，创伤-出血后继发败血症的发情前期雌性的存活率明显高于同龄雄性或去卵巢雌性。在这方面，雄性的败血症或创伤会导致器官功能和免疫反应下降，而雌性则不变或增强。本文综述了研究表明，在败血症、创伤或再灌注损伤的实验模型中，雌激素通过何种机制调节大脑神经、肺和心脏系统。
