感染中毒症25例临床观察(2)
感染中毒症发生的根本原因在于机体过度释放细胞因子及炎性介质导致炎性反应失控和免疫机能紊乱。机体对于感染或其他打击,不仅产生过度的炎性反应,同时还伴有免疫功能低下,这也是临床拮抗炎性因子治疗失败的原因之一[3]。而静脉推注用免疫球蛋白(IVIG)含有丰富的IgG型抗体,具有封闭单核巨噬细胞表面的Fc受体,中和循环中的自身抗体,以及调节细胞因子独特型网络,抑制细胞因子的生物学活性等作用;同时还可以提高中性粒细胞吞噬和杀菌能力,辅助抗生素对感染的治疗作用[4]。Rodriguez等[5]研究表明大剂量IVIG联合足量抗生素可以提高腹部感染中毒症患者的存活率。本研究尝试应用IVIG治疗感染中毒症,疗效较好,且IVIG不良反应少且轻微,偶出现一过性头昏伴恶心、一过性低热,经过处理均可缓解。
参考文献
[1] Edward Abraham.Coagulation abnormalities in acute lung injury and sepsis.Am J Respir Cell Mol Biol,2000,22(1):401-404.
[2] Bone RC,Balk RA,Cerra FB,et al.Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.Chest,1992,101(3):1644.
[3] 林洪远,盛志勇.感染中毒症免疫调理治疗的新思路.中国危重病急救医学,2004,16(1):67.
[4] Ballow M.Clinica1 and investigationa1 considerations for the use of IⅥG therapy.Am J Health Syst Pharm,2005,15(1):12-16.
[5] Rodriguez A,Rello J,Neira J,et al.Effects of high-dose of intravenous immunoglobulin and antibiotics on survival for severe sepsis undergoing surgery.Shock,2005,23(2):298-301.
, 百拇医药(郑立学 毛红菊)
参考文献
[1] Edward Abraham.Coagulation abnormalities in acute lung injury and sepsis.Am J Respir Cell Mol Biol,2000,22(1):401-404.
[2] Bone RC,Balk RA,Cerra FB,et al.Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis.Chest,1992,101(3):1644.
[3] 林洪远,盛志勇.感染中毒症免疫调理治疗的新思路.中国危重病急救医学,2004,16(1):67.
[4] Ballow M.Clinica1 and investigationa1 considerations for the use of IⅥG therapy.Am J Health Syst Pharm,2005,15(1):12-16.
[5] Rodriguez A,Rello J,Neira J,et al.Effects of high-dose of intravenous immunoglobulin and antibiotics on survival for severe sepsis undergoing surgery.Shock,2005,23(2):298-301.
, 百拇医药(郑立学 毛红菊)