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为什么脓毒症患者出院后仍病情未愈?

Why Septic Patients Remain Sick After Hospital Discharge?

机构信息

Interdisciplinary Post-Graduate Program in Health Sciences, Cruzeiro do Sul University, Sao Paulo, Brazil.

Immunobiological Production Section, Bioindustrial Center, Butantan Institute, São Paulo, Brazil.

出版信息

Front Immunol. 2021 Feb 15;11:605666. doi: 10.3389/fimmu.2020.605666. eCollection 2020.

Abstract

Sepsis is well known to cause a high patient death rate (up to 50%) during the intensive care unit (ICU) stay. In addition, sepsis survival patients also exhibit a very high death rate after hospital discharge compared to patients with any other disease. The addressed question is then: why septic patients remain ill after hospital discharge? The cellular and molecular mechanisms involved in the high rate of septic patient deaths are still unknown. We described herein the studies that investigated the percentage of septic patients that died after hospital discharge ranging from 90 days up to 5 years. We also reported the symptoms of septic patients after hospital discharge and the development of the recently called post-sepsis syndrome (PSS). The most common symptoms of the PSS are cognitive disabilities, physical functioning decline, difficulties in performing routine daily activities, and poor life quality. The PSS also associates with quite often reinfection and re-hospitalization. This condition is the cause of the high rate of death mentioned above. We reported the proportion of patients dying after hospital discharge up to 5 years of followed up and the PSS symptoms associated. The authors also discuss the possible cellular and metabolic reprogramming mechanisms related with the low survival of septic patients and the occurrence of PSS.

摘要

败血症众所周知会导致重症监护病房(ICU)住院患者死亡率高达 50%。此外,与患有其他任何疾病的患者相比,败血症存活患者在出院后也表现出极高的死亡率。那么,被关注的问题是:为什么败血症患者在出院后仍然病情恶化?败血症患者高死亡率涉及的细胞和分子机制尚不清楚。本文描述了研究败血症患者出院后 90 天至 5 年内死亡率的研究。我们还报告了败血症患者出院后的症状以及最近被称为败血症后综合征(PSS)的发展情况。PSS 的最常见症状包括认知障碍、身体机能下降、日常活动能力下降以及生活质量较差。PSS 还经常与再次感染和再次住院相关。这种情况就是导致上述死亡率高的原因。我们报告了出院后随访 5 年内死亡的患者比例以及与 PSS 相关的症状。作者还讨论了与败血症患者存活率低和 PSS 发生相关的可能的细胞和代谢重编程机制。

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