Su Heyi, Mo Zexun, Chen Zhen, Guo Zhenhui
Department of Geriatric Critical Care Medicine, Guangzhou General Hospital of Guangzhou Military Command, Guangdong Provincial Key Laboratory of Geriatric Infection and Organ Function Support, Guangzhou Key Laboratory of Geriatric Infection and Organ Function Support, Guangzhou 510010, Guangdong, China. Corresponding author: Guo Zhenhui, Email:
Zhonghua Wei Zhong Bing Ji Jiu Yi Xue. 2017 Aug;29(8):760-764. doi: 10.3760/cma.j.issn.2095-4352.2017.08.019.
Terminology of persistent inflammation immunosuppression and catabolism syndrome (PICS) is developed based on the concept of multiple organ failure (MOF), which reflect that the preponderance is gradually reversed from pro-inflammation to anti-inflammation, and eventually the state of simultaneously persistent inflammation and severe immunosuppression appeared. Although the improvement of rescue technology and management increase the early survival rates of patient with critical illnesses, the long-term outcomes of most patients are not optimistic. The patients with PICS are difficult to treat or prevent, and are likely to indolent death and have a rising incidence, which is an important challenge to the intensive care unit (ICU). The paper review the understanding of PICS, summarize the specific changes of immune system in PICS, and explore the immunological markers for early recognition of PICS and judgment of immune state in order to provide new thinking for prevention and control of PICS.
持续性炎症、免疫抑制和分解代谢综合征(PICS)的术语是基于多器官功能衰竭(MOF)的概念发展而来的,这反映出优势状态正逐渐从促炎向抗炎转变,最终出现了持续性炎症和严重免疫抑制同时存在的状态。尽管抢救技术和管理的改进提高了危重病患者的早期生存率,但大多数患者的长期预后并不乐观。患有PICS的患者难以治疗或预防,且可能会悄无声息地死亡,其发病率呈上升趋势,这对重症监护病房(ICU)来说是一项重大挑战。本文回顾了对PICS的认识,总结了PICS中免疫系统的具体变化,并探索用于早期识别PICS和判断免疫状态的免疫学标志物,以便为PICS的防控提供新的思路。