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脓毒症中的中性粒细胞功能障碍

Neutrophil Dysfunction in Sepsis.

作者信息

Zhang Fang, Liu An-Lei, Gao Shuang, Ma Shui, Guo Shu-Bin

机构信息

Department of Emergency Medicine, Peking Union Medical College Hospital, Beijing 100730, China.

Department of Intensive Care Medicine, Beijing Jishuitan Hospital, Beijing 100035, China.

出版信息

Chin Med J (Engl). 2016 Nov 20;129(22):2741-2744. doi: 10.4103/0366-6999.193447.

Abstract

OBJECTIVE

Sepsis is defined as life-threatening organ dysfunction due to a dysregulated host response to infection. In this article, we reviewed the correlation between neutrophil dysfunction and sepsis.

DATA SOURCES

Articles published up to May 31, 2016, were selected from the PubMed databases, with the keywords of "neutrophil function", "neutrophil dysfunction", and "sepsis".

STUDY SELECTION

Articles were obtained and reviewed to analyze the neutrophil function in infection and neutrophil dysfunction in sepsis.

RESULTS

We emphasized the diagnosis of sepsis and its limitations. Pathophysiological mechanisms involve a generalized circulatory, immune, coagulopathic, and/or neuroendocrine response to infection. Many studies focused on neutrophil burst or cytokines. Complement activation, impairment of neutrophil migration, and endothelial lesions are involved in this progress. Alterations of cytokines, chemokines, and other mediators contribute to neutrophil dysfunction in sepsis.

CONCLUSIONS

Sepsis represents a severe derangement of the immune response to infection, resulting in neutrophil dysfunction. Neutrophil dysfunction promotes sepsis and even leads to organ failure. Mechanism studies, clinical practice, and strategies to interrupt dysregulated neutrophil function in sepsis are desperately needed.

摘要

目的

脓毒症被定义为因宿主对感染的反应失调而导致的危及生命的器官功能障碍。在本文中,我们综述了中性粒细胞功能障碍与脓毒症之间的相关性。

数据来源

从PubMed数据库中选取截至2016年5月31日发表的文章,关键词为“中性粒细胞功能”“中性粒细胞功能障碍”和“脓毒症”。

研究选择

获取并审阅文章以分析感染中的中性粒细胞功能及脓毒症中的中性粒细胞功能障碍。

结果

我们强调了脓毒症的诊断及其局限性。病理生理机制涉及对感染的全身性循环、免疫、凝血及/或神经内分泌反应。许多研究聚焦于中性粒细胞爆发或细胞因子。补体激活、中性粒细胞迁移受损及内皮损伤参与了这一过程。细胞因子、趋化因子及其他介质的改变导致脓毒症中的中性粒细胞功能障碍。

结论

脓毒症代表了对感染的免疫反应严重紊乱,导致中性粒细胞功能障碍。中性粒细胞功能障碍促进脓毒症发展甚至导致器官衰竭。迫切需要对脓毒症中失调的中性粒细胞功能进行机制研究、临床实践及干预策略。

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