烧创伤脓毒症免疫状态精准评估及其价值

Precision evaluation of immune status and its significance in sepsis after burns or trauma

严重烧伤、创伤和出血引起的脓毒症仍然是重症监护病房患者死亡的主要原因，且可能导致宿主天然免疫及获得性免疫反应的广泛激活和功能障碍。大量有关脓毒症中天然免疫和获得性免疫细胞亚群的研究证实，这些免疫细胞，包括中性粒细胞、巨噬细胞、树突状细胞、T淋巴细胞、调节性T淋巴细胞和自然杀伤细胞，在急性损伤或脓毒症时通过调节受体表达或细胞因子分泌影响免疫反应，影响着脓毒症的发展和结局。因此，准确监测脓毒症患者的免疫状态及其相关指标，对评估继发感染的危险性，判断脓毒症的预后，并指导感染并发症的治疗具有重要意义。

Sepsis induced by major burns, trauma, and hemorrhage, remains a major cause of death of patients in inten-sive care units, and it may resuh in both the widespread activa-tion and dysfunction of the innate as well as adaptive responses in host immune system. A large amount of information concern-ing subsets of innate and adaptive immune ceils in sepsis has im-plicated that these cells, including neutrophils, macrophages, dendritic cells, T lymphocytes, regulatory T lymphocytes, and natural killer ceils, have profound effects on immunoreactivity during acute insults or sepsis through modulating multiple recep-tor expressions or cytokine secretion, in turn contributing to the development and outcome of sepsis. It is of great significance that precision monitoring of immune function and the related in-dicators might help to assess the risk of secondary infection, the prognosis of septic patients, and guide the treatment of septic complications.