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2016欧洲危重症医学会(The European Society of Intensive Care Medicine,ESICM)和美国危重症医学会(The Society of Critical Care Medicine,CCM)发表了关于脓毒症的第三届国际共识,对其定义做出了新的调整,即机体对感染的异常反应引起的危及生命的器官功能障碍,在临床上,器官功能障碍表现为序贯器官功能评分(SOFA)大于等于2分。脓毒症的病理生理涉及多个方面,本文从全身炎症网络效应和免疫功能障碍方面做了系统阐述,指出了TLR4/CD14/MD2-My D88-IRAKs-TRAF6-TAK-1-MAPKKK—MKK3-p38MAPK在整个炎症通路的作用,以及脓毒症时免疫抑制的机制。另外,总结了近年来乌司他丁治疗脓毒症方面的新进展,以及对乌司他丁药理作用机制的新探索,为乌司他丁治疗脓毒症肝损伤治疗机制的探索提供进一步的理论支持。
2016 The Third International Consensus on Sepsis, published by the European Society of Intensive Care Medicine (ESICM) and The Society of Critical Care Medicine (CCM), defines its definition A new adjustment, the life-threatening organ dysfunction caused by the abnormal response of the organism, has been clinically manifested as a sequential organ function score (SOFA) score of 2 or greater. The pathophysiology of sepsis involves many aspects. This article systematically elaborates on the systemic inflammatory network effects and immune dysfunction and points out that TLR4 / CD14 / MD2-My D88-IRAKs-TRAF6-TAK-1-MAPKKK- The role of p38MAPK in the entire inflammatory pathway, as well as the mechanism of immunosuppression in sepsis. In addition, the recent advances in the treatment of sepsis with ulinastatin and the new exploration of the mechanism of action of ulinastatin are summarized, providing a further exploration of the therapeutic mechanism of ulinastatin in septic liver injury Theoretical support.