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重症监护病房与脓毒症:髓系和淋巴细胞免疫细胞的作用

ICU and Sepsis: Role of Myeloid and Lymphocyte Immune Cells.

作者信息

Wang Anxiu, Zhang Su, Peng Guangming, Tang Yuanxu, Yang Yaopeng

机构信息

Geriatrics Department, People's Hospital of Yuxi City, Yuxi 653100, China.

Emergency Medicine Department, People's Hospital of Yuxi City, Yuxi 653100, China.

出版信息

J Oncol. 2022 Sep 25;2022:7340266. doi: 10.1155/2022/7340266. eCollection 2022.

Abstract

Sepsis is a severe immune system reaction to infection and a major cause of ICU-related fatalities. Because of the high mortality, high cost of treatment, and complex aetiology of sepsis, sepsis has a huge impact on healthcare. Some of the health complications in sepsis are abnormal cardiac functions, hypoperfusion, hypotension, tissue damage, multiple organ failure, and ultimately death. Individuals with weak immune systems and chronic medical conditions are highly vulnerable to sepsis. In sepsis, a patient shows the extreme immune response in the initial stage while prolonged immunosuppression in the later stages. Sepsis-driven immunosuppression ushers in death because sepsis cases develop secondary infections postrecovery. The later immunocompromised state in sepsis is attributed myeloid-derived suppressor cell upregulation and reduced immune activity displayed by lymphocytes (lymphocyte anergy). As a result, it is currently suggested that regulating the immune response is a better therapeutic approach than focusing on inflammation to improve the immune system's capacity to fight infections. Moreover, finding novel and accurate prognostic biomarkers that can help in rapid sepsis diagnoses and deciding better therapeutic strategies will significantly lower clinical case mortality rates.

摘要

脓毒症是免疫系统对感染的严重反应,是重症监护病房相关死亡的主要原因。由于脓毒症死亡率高、治疗成本高且病因复杂,对医疗保健产生了巨大影响。脓毒症的一些健康并发症包括心功能异常、灌注不足、低血压、组织损伤、多器官衰竭,最终导致死亡。免疫系统较弱和患有慢性疾病的个体极易患脓毒症。在脓毒症中,患者在初始阶段表现出极端免疫反应,而在后期则出现长期免疫抑制。脓毒症驱动的免疫抑制导致死亡,因为脓毒症病例在康复后会发生继发性感染。脓毒症后期的免疫功能低下状态归因于髓源性抑制细胞上调和淋巴细胞显示的免疫活性降低(淋巴细胞无反应性)。因此,目前建议调节免疫反应比专注于炎症以提高免疫系统抗感染能力是更好的治疗方法。此外,找到能够帮助快速诊断脓毒症并制定更好治疗策略的新型准确预后生物标志物将显著降低临床病例死亡率。

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