脓毒血症的研究机制及免疫炎症因子吸附装置

Sepsis and development of immunosorbent device to clear over-expressed inflammatory cytokines

脓毒血症是机体感染后引起的一种全身性免疫应答,进展到后期可发展为脓毒血症休克、多器官衰竭甚至死亡。研究表明在脓毒血症的早期阶段,天然免疫系统被激活以便清除入侵细菌,如果控制不当,脓毒症引起细胞因子风暴特别是TNF、IL-1、IL-6等促炎因子大量释放从而加重炎症反应;到了晚期阶段由于巨噬细胞失活,抗炎因子增加则表现为免疫抑制状态。目前临床对于脓毒血症的治疗除了基础的对症用药外,还用血液净化装置以辅助缓解症状。本文通过文献检索,分析比较国内外常用免疫吸附装置的作用原理及优缺点,以期阐明免疫吸附装置在脓毒血症治疗中的前景及改进设想。

Sepsis is a systemic immune response caused by infection,which can progress to septic shock,multiple organ failure and even death in the later stage.In the early stage of sepsis,the innate immune system is activated,followed by releasing a large number of pro-inflammatory factors such as TNF,IL-1 and IL-6 which aggravate the inflammatory response.In the late stage,due to the inactivation of macrophages,increased anti-inflammatory factors may lead to immunosuppression.At present,there is no effective treatment for sepsis,in addition to the basic drugs to manage symptoms,the auxiliary role of blood purification and toxin cleansing devices is also very important.This review aims at analyzing and comparing the principles,advantages and disadvantages of immunosorbent devices commonly used at home and abroad,to provide the updated information of immunosorbent devices for the treatment of sepsis.