重症社区获得性肺炎治疗的现状与展望

Current status and prospect of treatment for severe community acquired pneumonia

重症社区获得性肺炎(SCAP)由于其较高的发病率和病死率,引起了领域内的高度重视.SCAP常合并多器官功能障碍综合征(MODS)和脓毒症(sepsis),提示在提高病原学检出率和优化抗菌药物治疗措施外,还需要改善器官功能状态,减轻器官损伤,改善凝血纤溶,促进器官和免疫修复等措施.中和抗体、皮质激素、免疫调节剂、中医中药等均可从不同角度改善器官功能,尤其是中医中药的辨证施治和多靶点的治疗措施,成为SCAP和MODS治疗的新方法.中西医结合在SCAP的治疗上有望走出一条新的道路.

Severe community acquired pneumonia (SCAP) has raised substantial concern due to high morbidity and mortality. SCAP is usually associated with multiple organ dysfunction syndrome (MODS) and sepsis. It is suggested that organ function and coagulation/fibrinolysis improvement, organ injury reduction and organ repair facilitation are highly required besides microbiology detection and optimization of antibiotics strategy on treatment of SCAP. Neutralization antibody, steroid, immunmodulatory therapy, and Chinese medicine etc. contribute to organ function improvement from different perspective. The unique profile of multiple target and personalized therapy of Chinese medicine may become a promising new option for SCAP and MODS. The combination of Western and Chinese Medicine shed new light on SCAP treatment.