革兰氏阴性菌血症治疗的新进展。
New developments in the treatment of gram-negative bacteremia.
作者信息
Jacobson M A, Young L S
出版信息
West J Med. 1986 Feb;144(2):185-94.
Abstract
Gram-negative bacteremia is an increasingly important nosocomial infectious problem. Endotoxin, endorphins, leukocyte agglutination and deficient opsonization all appear to be major factors in the pathogenesis of Gram-negative septic shock. Outcome has previously correlated best to underlying disease state. With appropriate double antibiotic therapy and hemodynamic support, however, mortality has decreased even for neutropenic patients. Corticosteroids, naloxone, granulocyte transfusions and immunotherapy are experimental adjunctive modes of therapy that offer hope for even better survival in the future.
摘要
革兰阴性菌血症是一个日益重要的医院感染问题。内毒素、内啡肽、白细胞凝集和调理素缺乏似乎都是革兰阴性菌败血症休克发病机制中的主要因素。此前，预后与基础疾病状态的相关性最强。然而，通过适当的双联抗生素治疗和血流动力学支持，即使是中性粒细胞减少的患者死亡率也有所下降。皮质类固醇、纳洛酮、粒细胞输注和免疫疗法是实验性辅助治疗方式，为未来更好的生存率带来了希望。
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Corticosteroids block binding of chemotactic peptide to its receptor on granulocytes and cause disaggregation of granulocyte aggregates in vitro.皮质类固醇可阻断趋化肽与其在粒细胞上的受体的结合，并在体外导致粒细胞聚集体解聚。
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