Department of General, Visceral, and Transplant Surgery, Ludwig Maximilians-University Munich, 81377, Munich, Germany.
Center for Surgical Research and Department of Surgery, University of Alabama at Birmingham, Birmingham, AL, 35294, USA.
Mil Med Res. 2018 Oct 26;5(1):35. doi: 10.1186/s40779-018-0182-5.
Despite efforts in prevention and intensive care, trauma and subsequent sepsis are still associated with a high mortality rate. Traumatic injury remains the main cause of death in people younger than 45 years and is thus a source of immense social and economic burden. In recent years, the knowledge concerning gender medicine has continuously increased. A number of studies have reported gender dimorphism in terms of response to trauma, shock and sepsis. However, the advantageous outcome following trauma-hemorrhage in females is not due only to sex. Rather, it is due to the prevailing hormonal milieu of the victim. In this respect, various experimental and clinical studies have demonstrated beneficial effects of estrogen for the central nervous system, the cardiopulmonary system, the liver, the kidneys, the immune system, and for the overall survival of the host. Nonetheless, there remains a gap between the bench and the bedside. This is most likely because clinical studies have not accounted for the estrus cycle. This review attempts to provide an overview of the current level of knowledge and highlights the most important organ systems responding to trauma, shock and sepsis. There continues to be a need for clinical studies on the prevailing hormonal milieu following trauma, shock and sepsis.
尽管在预防和重症监护方面做出了努力，但创伤和随后的败血症仍然与高死亡率相关。创伤仍然是 45 岁以下人群死亡的主要原因，因此给社会和经济带来了巨大的负担。近年来，有关性别医学的知识不断增加。许多研究报告了在创伤、休克和败血症反应方面的性别二态性。然而，女性在创伤性出血后获得有利结果并不仅仅是因为性别。相反，这是由于受害者普遍的激素环境。在这方面，各种实验和临床研究表明，雌激素对中枢神经系统、心肺系统、肝脏、肾脏、免疫系统以及宿主的整体生存都有有益的影响。尽管如此，从实验室到临床仍存在差距。这很可能是因为临床研究没有考虑到发情周期。这篇综述试图概述目前的知识水平，并强调对创伤、休克和败血症反应最重要的器官系统。仍然需要对创伤、休克和败血症后流行的激素环境进行临床研究。
