创伤后免疫抑制的研究进展

Research Advance of Post-traumatic Immunosuppression

创伤后,机体启动一系列免疫反应来抑制创伤部位炎症,修复、重塑损伤组织。创伤部位损伤细胞及固有免疫细胞释放一系列炎性介质与机体免疫系统、内分泌系统、肝脏、肠道形成复杂关系。免疫反应进一步发展导致免疫功能抑制,是创伤后患者罹患院内获得性肺炎、全身炎症反应综合征、多器官功能障碍综合征及死亡的主要原因。目前,免疫功能抑制的机制研究尚不成熟,临床上缺乏规范统一的认识。

After trauma,the human immune system initiates a series of inflammatory events at the injury site that is later followed by suppression of local inflammation favoring the repair and remodeling of the damaged tissues. This local immune response involves complex interactions between inflammatory medium released by local resident cells and recruited cells,and immune system,endocrine system,liver and intestine. The initial immune responses may have systemic consequences resulting in a state called post-traumatic immunosuppression which is one of the leading causes of post-surgical mortality and makes patients vulnerable to hospital-acquired pneumonia,systemic inflammatory response syndrome,and multiple organ dysfunction syndrome. Post-traumatic immunosuppression has been intensively studied,but published results are frequently cloudy.