Heggers J P
Clin Plast Surg. 1979 Oct;6(4):505-13.
Severe injury, whether the result of a major accident, a large burn, or a complicated surgical operation, often results in sepsis. Under such conditions both specific and nonspecific host defense systems are affected. The individual facets of major concern are chemotaxis, phagocytosis, intracellular killing, complement depletion, and depression of humoral and cellular mediated immunity. The most profound changes occur in cell-mediated immunity. Within a few hours o injury, the number of circulating T cells becomes depleted, concomitantly thoracic duct lymphocytes are markedly reduced. This change is not only quantitative but functional. The clinical impact of these deficient host defense mechanisms lies in the fact that low virulent organisms may become a lethal threat to the injured patient. Currently, investigators are attempting to reverse thse deficiencies through the use of immunotherapy.
严重损伤,无论是重大事故、大面积烧伤还是复杂的外科手术的结果,往往都会导致败血症。在这种情况下,特异性和非特异性宿主防御系统都会受到影响。主要关注的各个方面包括趋化性、吞噬作用、细胞内杀伤、补体耗竭以及体液和细胞介导免疫的抑制。最显著的变化发生在细胞介导免疫中。受伤后数小时内,循环T细胞数量减少,同时胸导管淋巴细胞显著减少。这种变化不仅是数量上的,也是功能上的。这些宿主防御机制缺陷的临床影响在于,低毒力的生物体可能对受伤患者构成致命威胁。目前,研究人员正试图通过免疫疗法来扭转这些缺陷。