Department of Intensive Care, Erasme University Hospital, Université libre de Bruxelles, route de Lennik 808, 1070, Bruxelles, Belgium.
Crit Care. 2017 Dec 28;21(Suppl 3):314. doi: 10.1186/s13054-017-1910-z.
Recent advances in technology and better understanding of mechanisms underlying disease are beginning to enable us to better characterize critically ill patients. Instead of using nonspecific syndromic groupings, such as sepsis or acute respiratory distress syndrome, we can now classify individual patients according to various specific characteristics, such as immune status. This "personalized" medicine approach will enable us to distinguish patients who have similar clinical presentations but different cellular and molecular responses that will influence their need for and responses (both negative and positive) to specific treatments. Treatments will be able to be chosen more accurately for each patient, resulting in more rapid institution of appropriate, effective therapy. We will also increasingly be able to conduct trials in groups of patients specifically selected as being most likely to respond to the intervention in question. This has already begun with, for example, some new interventions being tested only in patients with coagulopathy or immunosuppressive patterns. Ultimately, as we embrace this era of precision medicine, we may be able to offer precision therapies specifically designed to target the molecular set-up of an individual patient, as has begun to be done in cancer therapeutics.
最近在技术上的进步和对疾病潜在机制的更好理解，开始使我们能够更好地描述危重病患者。我们现在可以根据各种特定特征（如免疫状态）对个体患者进行分类，而不是使用非特异性综合征分组，如脓毒症或急性呼吸窘迫综合征。这种“个性化”医学方法将使我们能够区分具有相似临床特征但不同细胞和分子反应的患者，这些反应将影响他们对特定治疗的需求和反应（包括负面和正面反应）。可以更准确地为每个患者选择治疗方法，从而更快速地实施适当、有效的治疗。我们还将能够越来越多地在特定选择的最有可能对所讨论的干预措施产生反应的患者群体中进行试验。例如，已经开始在患有凝血功能障碍或免疫抑制模式的患者中仅测试某些新的干预措施。最终，随着我们接受精准医学时代，我们也许能够提供专门针对个体患者分子构成设计的精准治疗方法，这在癌症治疗中已经开始实施。
