摘要
由于脓毒症免疫反应的异质性、复杂的信号通路、促炎与抗炎的相互作用等诸多因素影响,脓毒症疗效及预后依然欠佳。脓毒症免疫抑制增加院内感染及死亡的风险。即使存活的患者通常也会出现长期的免疫抑制状态,是远期死亡的主要原因之一。此次新型冠状病毒肺炎(COVID-19)的流行,重型及危重型患者均符合脓毒症诊断标准。通过对脓毒症,尤其是重型、危重型COVID-19患者外周血辅助T细胞、调节性T细胞和CD8+T细胞研究,发现监测其变化趋势与脓毒症不同时期的免疫激活和免疫抑制显著相关。正确评估患者的免疫状态是个体化治疗的前提。本文综述了脓毒症T淋巴细胞亚群的变化,以期为精准治疗脓毒症和改善脓毒症患者的预后提供监测指标。
Although the understanding of the pathophysiological mechanism of sepsis has significantly improved,the outcome of septic patients remains poor.It is because of the heterogeneity of immune response,complex signaling pathways,the interplay of pro-inflammatory and anti-inflammatory processes and so on.Moreover,immunosuppression in sepsis increases the risk of death.Even survivors often remain a persistent immunosuppression status,which is one of the main reasons for long-term mortality.During pandemic of coronavirus disease 2019(COVID-19),severe COVID-19 patients also meet the diagnostic criteria of sepsis.In different periods of sepsis,there are close correlations between the counts of T cell subsets and immune status,demonstrated by monitoring peripheral helper T cells,regulatory T cells and CD8+T cells.The premise of appropriate treatment is to assess the patient's immune status precisely.Therefore,this review focuses on the change of T cell subsets counts,especially in patients with COVID-19,aiming to provide a monitoring indicator for precision immune treatment and improve outcome in sepsis.
作者
张思也
侯粲
钟燕军
伍国宝
Zhang Siye;Hou Can;Zhong Yanjun;Wu Guobao(Intensive Care Unit,Hunan Provincial People's Hospital/the First Hospital Affiliated with Hunan Normal University,the Clinical Medicine of Hunan Normal University,Changsha 410011,China;Intensive Care Unit,the Second Xiangya Hospital of Central South University,Changsha 410011,China;Department of Metabolism&Endocrinology,the Second Xiangya Hospital,Central South University,Key Laboratory of Diabetes Immunology(Central South University),Ministry of Education,National Clinical Research Center for Metabolic Diseases,Changsha 410011,China)
出处
《中华重症医学电子杂志》
CSCD
2021年第1期48-54,共7页
Chinese Journal Of Critical Care & Intensive Care Medicine(Electronic Edition)
基金
国家自然科学基金青年基金(81701962,81200580)。
