硫胺素抗坏血酸和糖皮质激素在脓毒症治疗中的研究进展

Research progress of thiamine,ascorbic acid and glucocorticoid in the treatment of sepsis

脓毒症是一种威胁生命的急症,发病率和病死率都很高,其特征是宿主对感染的反应失调。脓毒症和脓毒性休克的治疗策略主要包括感染源控制、抗感染药物应用以及液体复苏、器官功能支持、免疫调节等。迄今为止,还没有单一的药物和方法能够证明可以有效地降低脓毒性休克病死率或改善器官功能障碍。研究发现,硫胺素、抗坏血酸和氢化可的松的联合应用可有效预防进行性器官功能障碍并降低病死率。本文综述了硫胺素、抗坏血酸、糖皮质激素各自在脓毒症中的应用以及这些药物之间潜在的协同作用,并探讨了迄今为止联合应用研究的优缺点。

Sepsis is a life-threatening medical emergency with high morbidity and mortality. It is characterized by an imbalance in the host’s response to infection. Treatment strategies for sepsis and septic shock mainly include infection source control,anti-infective drugs,fluid resuscitation,organ function support,and immune regulation. So far,there is no single drug and method that can effectively reduce the mortality of septic shock or improve organ dysfunction. A recent study finds that the combination of thiamine,ascorbic acid and hydrocortisone can effectively prevent progressive organ dysfunction and reduce patients ’ mortality. This article reviews the application of thiamine,ascorbic acid,and glucocorticoid in sepsis and the potential synergy among these drugs,and discusses the advantages and disadvantages of the combined application so far.