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对创伤的系统性免疫反应:病理生理学和治疗的概述
Janet M Lord1, Mark J Midwinter2, Yen-Fu Chen3
1MRC-ARUK Centre for Musculoskeletal Ageing Research, School of Immunity and Infection, University of Birmingham, Birmingham, UK; NIHR Surgical Reconstruction and Microbiology Research Centre, University of Birmingham, Birmingham, UK.
Lancet (London, England)
|November 13, 2014
概括
大型创伤幸存者面临的风险不仅仅是失血,包括由于系统性炎症而导致的感染和器官衰竭. 年龄显著影响生存率,需要新的治疗方法来治疗受伤后的免疫调节障碍.
科学领域:
- 创伤生物学 创伤生物学
- 免疫学 免疫学 免疫学
- 关键护理医学 关键护理医学
背景情况:
- 血液控制方面的进步提高了创伤生存率.
- 然而,非脱血原因,如感染和器官衰竭,占创伤死亡的大多数.
- 创伤引发了全身炎症反应,矛盾的是,增加了对感染的易感性.
研究的目的:
- 检查创伤后系统性炎症和多器官衰竭的生物机制和临床影响.
- 探索年龄对创伤生存的流行病学影响.
- 讨论免疫失调和严重创伤后免疫力下降的新兴治疗方法.
主要方法:
- 关于创伤引起的炎症和免疫反应的生物学机制的审查.
- 对与年龄相关的创伤生存率的流行病学数据的分析.
- 讨论当前和新兴的治疗策略.
主要成果:
- 严重的创伤会引发一连串的炎症,导致多器官衰竭.
- 年龄是影响创伤患者结果的关键因素,独立于受伤严重程度.
- 了解炎症反应和衰老的影响是开发新治疗方法的关键.
结论:
- 尽管在控制出血方面取得了进展,但创伤后免疫失调和易受感染仍然是重大挑战.
- 炎症反应的年龄相关差异需要量身定制的治疗方法.
- 对抗免疫功能障碍的进一步研究对于改善重大创伤患者的治疗结果至关重要.
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