用血液灌流治疗内毒素血症的研究进展

Progress of the study on the treatment of endotoxemia by hemoperfusion

内毒素血症是由于血中细菌或病灶释放出大量内毒素至血液，或输入大量内毒素污染的液体而引起，它可促进全身炎症反应综合征、脓毒症、多器官功能障碍综合征的发生、发展，早期诊断并及时阻断，对于阻止细菌感染的进一步加剧、防治脓毒症等并发症具有积极意义。近年来，用血液灌流方法治疗内毒素血症已取得一些进展。通过直接吸附清除血液中的内毒素和炎性细胞因子，可使其浓度迅速降低，既减弱了其本身的活性，又抑制了其它有害因子的释放，从而改善感染症状。迄今为止，具有临床应用价值的特异性高效亲和吸附剂仍处于探索阶段，这些吸附材料对内毒素血症患者的治疗虽然取得了一定疗效．但仍需讲行深入的研究．以便更好地确定临床入诜标准，获得更满意的疗效。

Endotoxemia is due to the infection of bacteria or lesions which release a lot of toxins into the blood, or the infusing of large amount of endotoxin-contaminated liquid. It can cause systemic inflammatory response syndrome, sepsis, or multiple organ dysfunction syndrome. Endotoxemia is a common and complex problem in modern emergency medicine. Early diagnosis and timely blocking not only can prevent further infection hut also plays a positive role in the prevention and treatment of sepsis and its complications. In recent years, progresses have been made in the treatments of endotoxemia by hemoperfusion. The direct adsorption of endotoxin and inflammatory cytokines in blood can quickly reduce their concentration. This can not only weaken their own activity but also inhibit the release of other harmful cytokines, so as to improve the symptoms of infection. So far, the specific highaffinity adsorbents having the clinical value are still at the exploratory stage. Although these materials were found effective in the treatments of endotoxemia, in-depth study need to be carried out on their clinical criteria in order to acquire more satisfied results.