脓毒症的病理生理机制研究进展

Progress in pathophysiological mechanism of sepsis

脓毒症是危重症患者严重的并发症和死亡的主要原因,其发病机制和病情变化复杂,因其病理生理机制并未完全被阐明,脓毒症的诊断和治疗仍在积极探索,2021年更新脓毒症治疗指南中持续沿用脓毒症3.0定义,即脓毒症是宿主对感染的失调反应而引起的危及生命的器官功能障碍,该定义以新的角度认识脓毒症的发病本质。本文以脓毒症患者自身失衡的炎症反应和全身多器官衰竭为基础,讨论了脓毒症炎症反应动态平衡机制,中性粒细胞胞外诱捕网、炎症小体、细胞焦亡、细胞凋亡以及内皮细胞功能障碍在脓毒症的病理生理机制中发挥的作用,并概括相关的生物分子标志物和治疗靶点,为实现脓毒症患者的综合评价提供诊断方向和治疗思路,提高患者生存率。

Sepsis is a leading cause of serious complications and death in critically ill patients. For the pathogenesis and the ill conditions of spesis are complex, pathophysiology has not been clearly clarified, and the diagnosis and treatment of sepsis is still in active exploration. The definition of sepsis 3.0 continues to be used in the sepsis treatment guidelines 2021, which defines sepsis as a life-threatening organ dysfunction caused by host dysregulated response to infection from a new view of sight. This paper based on the dysfunction of immune response and systemic multiple organ failure of sepsis patients discusses the dynamic balance mechanism of sepsis inflammatory response, neutrophil extracellular trap net, inflammatory bodies, cytokewal death, apoptosis and endothelial cell dysfunction in the pathophysiology mechanism of sepsis, and summarizes the corresponding mechanisms involved in the markers that can be used in the diagnosis of biological molecules targeted drugs and treatment, for the purpose of achieving the comprehensive diagnosis and treatment, improving the survival rate of patients..