摘要
脓毒症及由其发展而致的多器官功能障碍严重威胁着人类的生命健康,是危重症领域亟待解决的热点问题。脓毒症是具有异质性的、由感染诱发的、以内皮功能障碍为病理生理基础的全身炎症反应综合征,迄今仍是全球卫生系统的巨大负担,而内皮细胞作为一种公认的免疫细胞,是外来病原体、毒素或机体内源性损伤信号首要的攻击部位。外来病原体等物质使得内皮细胞发生活化,进而对内皮细胞的功能或结构造成破坏,由此内皮细胞将从正常抗炎、抗凝血的生理状态转变为促炎、促凝血的病理状态,尽管后者在一定程度上有助于消除感染、限制病灶的播散,但过度和持续的炎症反应也将导致后续炎性因子风暴和器官损伤的发生,对机体造成不可逆的损害。糖萼是内皮细胞表面的首层屏障,也是脓毒症时内皮细胞受到攻击的第一道防线,对保护内皮功能有重要意义,由糖萼参与的多种免疫炎症反应亦在脓毒症发展过程中起关键作用。本文对脓毒症时引起糖萼损伤的因素、机制,以及以糖萼为靶点的多种治疗手段进行综述。
Sepsis and its development of multiple organ dysfunction pose a serious threat to human life and health.Sepsis is a hot issue that experts in the critical field are committed to solve.It is a heterogeneous,infection-induced systemic inflammatory response syndrome based on endothelial dysfunction,and it is still a huge burden on the global health system.As a well recognized immune cell,the endothelium is the primary site of attack by pathogens,toxins,or endogenous injury signals,which cause activation of endothelial cells and consequently damage to their function or structure.Although the latter may help to eliminate the infection and limit the dissemination of the infection to some extent,the excessive and persistent inflammatory response will also lead to a subsequent storm of cytokine and organ damage,causing irreversible damage to the organism.Glycocalyx is the first barrier on the surface of endothelial cells,it is also the first line of defence for endothelial cells under attack in sepsis,which has a great significance on endothelial function.Many studies have found that a variety of immune inflammatory responses involving the glycocalyx also play a key role in the development of sepsis.This review will give a brief overview of the factors,mechanisms and various treatments targeting glycocalyx injury in sepsis at present.
作者
林源希
李真玉
Lin Yuan-Xi;Li Zhen-Yu(Department of Critical Care Medicine,the Second Hospital of Tianjin Medical University,Tianjin 300211,China)
出处
《解放军医学杂志》
CAS
CSCD
北大核心
2022年第10期1049-1056,共8页
Medical Journal of Chinese People's Liberation Army
关键词
脓毒症
内皮
血管
糖萼
sepsis
endothelium
vascular
glycocalyx
