脓毒症免疫炎症反应紊乱机制及治疗对策.pdfVIP

脓毒症免疫功能紊乱机制 及治疗对策 中国人民解放军第309医院重症医学科 张玉想 163.com 机体的免疫系统及调节途经 STRESS Physical stress Emotional stress Hypoglycemia Cold exposure Pain Sepsis Trauma Shock Surgery Annual Review of Immunology, Volume 20 ，2002 () Immune effector cells Immune Analysis of Cell Assay Methods Function Populations 树突状细胞 （Innate ） 巨噬细胞 先天性免疫 单核细胞 Flow cytometry, 自然杀伤细胞 immunohistochemistry （Adaptive ） T cells 获得性免疫 (CD4 and CD8) 免疫麻痹的概念 Tilting toward immunosuppression Proinflammatory Response Anti-Inflammatory Response TNF α IL-10 Characteristic cytokines IL-1 β TGF β IL-6 IL-1ra IL-8 sTNFr IL-17 IFN-γ IL-2 Innate immune function: Increased Decreased phagocytosis, intracellular killing, antigen presentation Adaptive immune cell types Th1, Th 17 Th2, Treg Simplified description of systemic pro- and anti-inflammatory immune responses over time after septic shock: Time matters!! Pro-inflammatory Response The anti-inflammatory surg