肠源性脓毒症的研究进展

Progress in gut-derived sepsis

脓毒症（sepsis）是创伤、烧伤、休克、感染等临床急危重病患者的严重并发症之一,也是诱发脓毒性休克、多器官功能障碍综合征（multiple organ dysfunction syndrome,MODS）的重要原因。胃肠道是人体最大的细菌及毒素库,胃肠道黏膜是抵御细菌入侵的重要屏障且极易受损伤。危重病患者由于缺氧、感染、应激等各种刺激使胃肠道屏障改变、胃肠道免疫功能抑制、肠道内细菌和毒素移位,参与MODS的发病,故胃肠道被认为是危重病应激的“中心器官”和MODS的“启动器”。关于肠源性脓毒症的研究方兴未艾,本文就其机制和防治的研究进展作一综述。

Sepsis is one of the severe complications in critically ill patients with trauma, burn, shock, or infection, and is also the major cause of septic shock and multiple organ dysfunction syndrome （MODS）. The gastrointestinal tract is the largest reservoir of bacteria and toxin in the human body and the mucosa is an important barrier to protect it from bacterial invasion and is very prone to injury. The gastrointestinal tract plays a key role in critical stress and MODS. The stimulus such as hypoxia, infection and stress in critically ill patients make the gastrointestinal mucosa barrier more vulnerable to disruption, immune function tosuppress, translocation of bacteria and toxin; therefore, participate in the development of MODS. So the gastrointestinal tract is considered as the ＂pivotal organ＂ of critical stress and the ＂rotor＂ of MODS. The research about gut-derived sepsis is rising. This paper reviews the progress in the mechanisms, prevention and therapy of gut-derived sepsis.