类固醇与胆固醇在脓毒症中的作用机制研究进展

Research progress on the mechanism of steroids and cholesterol in sepsis

脓毒症作为一种由感染诱发的一系列病理、生理以及生化异常综合征,是一种非常危重的临床疾病,也是导致患者出现危重症状的常见疾病,由于其致死率较高、早期明确诊断困难、治疗缺乏具体有效的治疗方案及预后指标不确定等特点,对患者的预后有严重的威胁,是目前重症医学面临的主要问题。脓毒症的发病机制非常复杂,不仅与炎症失控有关,还涉及内分泌代谢系统、神经系统、免疫系统和凝血系统等以及它们之间的相互作用,并与多器官病理生理改变密切相关。患有脓毒症者一般都伴随有严重感染以及应激反应,体内糖、蛋白质和脂肪三大营养物质代谢紊乱,表现为高血糖、负氮平衡,是一种高消耗的状态。在此过程中,类固醇和胆固醇均起到了非常重要的作用,是其中的重要介质。在脓毒症发病的过程中,使用一定剂量的类固醇以及胆固醇药物能够改善患者的病情,但是关于其作用机制说法较多,本文综述类固醇以及胆固醇在脓毒症中的作用机制研究进展。

As a series of pathological,physiological and biochemical abnormality syndrome induced by infection,sepsis is a very serious clinical disease,and it is also a common disease that causes patients to have critical symptoms,because of its high mortality rate,the difficulty of early definite diagnosis,the lack of specific and effective treatment and uncertain prognostic indicators,it is a serious threat to the prognosis of patients,it is the main problem that the serious disease medicine faces now.The pathogenesis of sepsis is very complex,not only related to inflammation out of control,but also involved in endocrine metabolism system,nervous system,immune system and coagulation system and their interaction,it is closely related to the pathophysiological changes of multiple organs.Patients with sepsis are usually accompanied by severe infection and stress response,the body sugar,protein and fat metabolism disorders,showing hyperglycemia,negative nitrogen balance,is a state of high consumption.In this process,steroids and cholesterol have played a very important role,is an important medium.In the course of sepsis,the use of certain doses of steroids and cholesterol drugs can improve the patient's condition,but there are many theories about the mechanism,this article reviews the research progress of steroids and the mechanism of cholesterol in sepsis.