葡萄糖皮质类药物和侵入性真菌感染
Michail S Lionakis1, Dimitrios P Kontoyiannis
1Department of Infectious Diseases, Infection Control and Employee Health, University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Lancet (London, England)
|December 5, 2003
概括
患有高皮质醇症的患者,由于库辛综合征或葡萄糖皮质醇治疗,面临侵入性真菌感染的风险增加. 了解这种联系有助于早期检测和治疗,这表明减少葡萄糖皮质激素治疗可能会改善结果.
科学领域:
- 免疫学 免疫学 免疫学
- 传染性疾病 传染性疾病
- 内分泌学 在内分泌学.
背景情况:
- 机会性真菌感染是免疫受损个体的主要死亡原因.
- 由于库辛综合征或葡萄糖皮质类药物使用的高皮质醇症,显著增加感染风险.
- 葡萄糖皮质类药物破坏免疫调节,增加对真菌病原体的脆弱性.
研究的目的:
- 审查在高皮质血症患者中侵入性真菌感染的谱和表现.
- 阐明葡萄糖皮质类药物在这些感染的发病过程中的作用.
- 改进对这些机会性感染的识别和治疗策略.
主要方法:
- 在高皮质血症状态下对侵入性真菌感染的文献综述.
- 分析葡萄糖皮质醇诱导免疫抑制的机制.
- 综合当前关于临床表现和病变发生的知识.
主要成果:
- 侵袭性真菌感染仅在高皮质血症患者中出现.
- 葡萄糖皮质类药物损害了免疫系统的多个部门,促进了真菌入侵.
- 详细介绍了特定的真菌物种及其临床表现.
结论:
- 对葡萄糖皮质类药物诱导的免疫抑制进行更深入的了解,对于治疗侵袭性真菌感染至关重要.
- 早期诊断和有针对性的治疗对于改善患者的治疗结果至关重要.
- 调节葡萄糖皮质激素治疗强度可以减轻这些感染的风险和严重程度.
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