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摘要: 严重烧伤的致死率一直处于较高水平。大量研究表明，严重烧伤患者快速出现感染症状、病情进展迅速与细胞因子风暴的发生密切相关，然而临床实践中对细胞因子风暴的监测预警及对症治疗尚处于探索阶段。该文就细胞因子风暴及关联的细胞因子、烧伤感染诱发细胞因子风暴的机制、预警及治疗进行综述，旨在为减轻严重烧伤患者感染程度、降低病死概率提供临床参考建议。Abstract: Mortality due to severe burns has always been at a high level. A large number of studies have shown that the rapid onset of infectious symptoms and rapid progression of severely burned patients are closely related to the occurrence of cytokine storm. However, in clinical practice, cytokine storm monitoring, early warning, and symptomatic treatment are still in exploratory stage. This article reviews the cytokine storm and its related cytokines, the mechanism, early warning, and treatment of cytokine storm induced by burn infection, aiming to provide clinical references for reducing infection and mortality in severely burned patients.
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Key words:
- Burns /
- Infection /
- Cytokine storm /
- Pathogenesis /
- Therapies
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参考文献
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表1 与细胞因子风暴相关联的6类细胞因子及其功能
类型 主要细胞因子 功能 CSF G-CSF、M-CSF、GM-CSF 刺激炎症细胞增殖和分化 IL IL-1~40 活化或诱导免疫细胞增殖和分化 趋化因子 CCL1~19、CXCL10/IP-10、CXCL12、CX3CL1 控制所有免疫细胞的迁移和归巢，参与炎症反应 干扰素 α干扰素、β干扰素、γ干扰素 激活巨噬细胞，诱导上皮细胞凋亡 生长因子 IGF、TGF-β、EGF、PDGF 促进细胞生长、分化和个体发育 TNF TNF-α、TNF-β 促进炎症反应，激活细胞毒性Ｔ淋巴细胞，调控细胞的增殖、存活、分化和凋亡 注：CSF为集落刺激因子，IL为白细胞介素，TNF为肿瘤坏死因子，G-CSF为粒细胞集落刺激因子，M-CSF为巨噬细胞集落刺激因子，GM-CSF为粒细胞巨噬细胞集落刺激因子，IP-10为γ干扰素诱导蛋白10，IGF为胰岛素样生长因子，TGF-β为转化生长因子β，EGF为表皮生长因子，PDGF为血小板衍生生长因子 
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