当前脓毒症研究的思考

Viewpoint on the current status of researches on sepsis

脓毒症是严重烧创伤后的常见并发症和主要致死原因之一。尽管近年来抗生素治疗取得了新的进展,但脓毒症病死率仍呈现不断上升的趋势,由其导致的死亡已超过前列腺癌、乳腺癌和艾滋病的总和,成为威胁人类健康的严重病症之一。本文介绍目前国际上公认的有关脓毒症、严重脓毒症和脓毒性休克的定义、诊断与治疗现状,指出脓毒症研究不仅要在发病机制和诊治上下工夫,还应更多地注重预防,从人体与致病因子间的相互作用和动态平衡方面寻找切入点。脓毒症防治的新策略应着眼于如何使强毒性感染因子变为无毒或弱毒性致病因子;在深入了解微生物生物学特性及其抗药性机制的基础上,研究如何使其失去保护机制,增加对药物的敏感性。

Sepsis is a common complication after severe trauma and burn, and also one of the main causes of death. Recently, although some new progresses were seen in antibiotic therapy, the mortality of sepsis is still on the rise, and the death rate as a result of sepsis is higher than a total of that of prostate cancer, breast cancer and AIDS. Therefore, sepsis has obviously become one of the serious ailments threatening human health. The present paper introduced the international definition of sepsis, severe sepsis and septic shock, the current researches on diagnosis and therapy, and proposed that we should not only pay attention to pathogenesis and treatment, but also to sepsis prevention in sepsis researches, and we should try to find out the breakthrough in the interaction and dynamic balance between human being and pathogenic factors. Researches on the strategies to revert strong toxicity of infectious agents to non-toxic or weak pathogenic factors, and to conduct further research concerning biological characteristics of microorganisms and mechanism of drug resistance in order to render them to lose the drug resistance ability, or to increase its sensitivity to the drugs. The above suggested approaches might form the future strategies for preventing and controlling sepsis.