切换至 "中华医学电子期刊资源库"

第五届中国出版政府奖音像电子网络出版物奖提名奖

中国科技核心期刊

中国科学引文数据库(CSCD)来源期刊

中华重症医学电子杂志 ›› 2021, Vol. 07 ›› Issue (02) : 169 -173. doi: 10.3877/cma.j.issn.2096-1537.2021.02.014

综述

脓毒症休克的诊治在精准医学时代下的发展及临床应用
张璐1, 李响1,(), 夏世宏1, 童琦1, 孙英杰1, 马雪丽1   
  1. 1. 201199 上海,复旦大学附属闵行医院重症监护室
  • 收稿日期:2020-09-29 出版日期:2021-05-28
  • 通信作者: 李响

Development and clinical application of the diagnosis and treatment of septic shock in the era of precision medicine

Lu Zhang1, Xiang Li1,(), Shihong Xia1, Qi Tong1, Yingjie Sun1, Xueli. Ma1   

  1. 1. Department of Intensive Care Unit, Minhang Hospital, Fudan University, Shanghai 201199, China
  • Received:2020-09-29 Published:2021-05-28
  • Corresponding author: Xiang Li
引用本文:

张璐, 李响, 夏世宏, 童琦, 孙英杰, 马雪丽. 脓毒症休克的诊治在精准医学时代下的发展及临床应用[J/OL]. 中华重症医学电子杂志, 2021, 07(02): 169-173.

Lu Zhang, Xiang Li, Shihong Xia, Qi Tong, Yingjie Sun, Xueli. Ma. Development and clinical application of the diagnosis and treatment of septic shock in the era of precision medicine[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2021, 07(02): 169-173.

脓毒症休克病情凶险,致死率高。精准医学作为新型医学概念,其医疗模式影响了众多肿瘤及慢性病患者,也为脓毒症的精确诊治带来曙光。同时临床操作技术、基因检测、分子生物学的发展为脓毒症的精准诊治提供了数据和信息,通过对脓毒症患者不同病理生理状态、生物标志物、病原学、基因组学的分析与鉴定来进行个性化精准诊治。本文就精准医学在脓毒症休克诊治中取得的进展进行综述,并对这种新医疗模式的未来进行展望。

Septic shock is a critical condition with high mortality. Precision medicine as a new medical concept has affected cancer and chronic disease patients which also bring the hope for the accurate diagnosis and treatment in patients with sepsis. The development of clinical operation technology, gene detection and molecular biology provides data and information for the accurate diagnosis and treatment of sepsis, and promotes the progress and innovation of the diagnosis and treatment. Personalized and accurate management can be perfomed according to different pathophysiological status, biomarkers, etiology, genomics and other aspects. We review the progress of precision medicine in the diagnosis and treatment of sepsis, and prospects the future of this new medical model.

1
Collins FS, Varmus H. A new initiative on precision medicine [J]. N Engl J Med, 2015, 372(9): 793-795.
2
Iwashyna TJ, Ely EW, Smith DM, et al. Long-term cognitive impairment and functional disability among survivors of severe sepsis [J]. JAMA, 2010, 304(16): 1787-1794.
3
Singer IM, Deutschman CS, Seymour CW, et al. The third international consensus definitions for sepsis and septic shock (sepsis-3) [J]. JAMA, 2016, 315(8): 801-810.
4
Angus DC, Linde-zwirble WT, Lidicker J, et al. Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care [J]. Crit Care Med, 2001, 29(7): 1303-1310.
5
Head LW, Coopersmith CM. Evolution of sepsis management: from early goal-directed therapy to personalized care [J]. Adv Surg, 2016, 50(1): 221-234.
6
Vijayan AL, Vanimaya, Ravindran S, et al. Procalcitonin: a promising diagnostic marker for sepsis and antibiotic therapy [J]. J Intensive Care, 2017, 5: 51-57.
7
Pierrakos C, Velissaris D, Bisdorff M, et al. Biomarkers of sepsis: time for a reappraisal [J]. Critical Care, 2020, 24(1): 287-301.
8
JäMSä J, Ala-Kokko T, Huotari V, et al. Neutrophil CD64, C-reactive protein, and procalcitonin in the identification of sepsis in the ICU - Post-test probabilities [J]. J Crit Care, 2018, 43:139-142.
9
Cohen J, Vincent JL, Adhikari NK, et al. Sepsis: a roadmap for future research [J]. Lancet Infect Dis, 2015, 15(5), 581-614.
10
苏磊,徐秋林. 精准医学时代的脓毒症研究 [J]. 中华急诊医学杂志, 2016, 25(2): 133-138.
11
Fatani SH, Alkhatib KH, Badr H, et al. Association of TNF-α-308 (G >A) (rs1800629) gene polymorphism with adverse outcomes of sepsis in critically ill patients [J]. DNA Cell Biol, 2020, 39(9): 1723-1729.
12
Wu Q, Xu X, Ren J, et al. Association between the -159C/T polymorphism in the promoter region of the CD14 gene and sepsis: a meta-analysis [J]. BMC Anesthesiol, 2017, 17(1): 11.
13
Sutherland AM, Walley KR, Russell JA. Polymorphisms in CD14, mannose-binding lectin, and Toll-like receptor-2 are associated with increased prevalence of infection in critically ill adults [J]. Crit Care Med, 2005, 33(3): 638-644.
14
Yende S, Angus DC, Kong L, et al. The influence of maemphage migration inhibitory factor gene polymorphisms on outcome from community-acquired pneumonia [J]. FASEB J, 2009, 23(8): 2403-2411.
15
Flores C, Ma SF, Maresso K, et al. IL6 gene-wide haplotype is associated with susceptibility to acute lung injury [J]. Transl Res, 2008, 152(1): 11-17.
16
Sutherland AM, Walley KR, Manocha S, et al. The association of interleukin 6 haplotype clades with mortality in critically ill adults [J]. Arch Intern Med, 2005, 165(1): 75-82.
17
Chen QX, Wu SJ, Wang HH, et al. Protein C -1641A/-1654C haplotype is associated with organ dysfunction and the fatal outcome of severe sepsis in Chinese Han population [J]. Hum Genet, 2008, 123(3): 281-287.
18
Russell JA, Wellman H, Walley KR. Protein C rs2069912 C allele is associated with increased mortality from severe sepsis in North Americans of East Asian ancestry [J]. Hum Genet, 2008, 123(6): 661-663.
19
Pachot A, Cazalis MA, Venet F, et al. Decreased expression of the fractalkine receptor CX3CR1 on circulating monocytes as new feature of sepsis-induced immunosuppression [J]. J Immunol, 2008, 180(9): 6421-6429.
20
Johnson SB, Lissauer M, Bochicchio GV, et al. Gene expression profiles differentiate between sterile SIRS and early sepsis [J]. Ann Surg, 2007, 245(4): 611-621.
21
Liu L, Ning B. The role of MBL2 gene polymorphism in sepsis incidence [J]. Int J Clin Exp Pathol, 2015, 8(11): 15123-15127.
22
Middleton EA, Rowley JW, Campbell RA, et al. Sepsis alters the transcriptional and translational landscape of human and murine platelets [J]. Blood, 2019, 134(12): 911-923.
23
刘大为, 王小亭, 张宏民, 等. 重症血流动力学治疗-北京共识 [J]. 中华内科杂志, 2015, 54(3): 248-271.
24
王小亭, 刘大为, 张宏民, 等. 扩展的目标导向超声心动图方案对感染性休克患者的影响 [J]. 中华医学杂志, 201l, 91(27):1879-1883.
25
沈延飞, 蔡国龙. 脓毒症相关微循环障碍的研究进展 [J/OL]. 中华重症医学电子杂志, 2020, 6(2): 160-164.
26
Seymour CW, Kennedy JN, Wang S, et al. Derivation, validation, and potential treatment implications of novel clinical phenotypes for sepsis [J]. JAMA, 2019, 321(20): 2003-2017.
27
Roberts JA, Abdul-aziz MH, Lipman J. etal. Individualised antibiotic dosing for patients who are criticalill: challengs and potential solutions [J] Lancet Infect Dis, 2014, 14(6): 498-509.
28
黄英姿, 邱海波. 药代动力学导向的重症感染患者抗生素个体化与精准化治疗 [J]. 中华内科杂志, 2016, 55(6): 425-427.
29
Jiwaji Z, Brady S, Mcintyre LA, et al. Emergency department management of early sepsis: a national survey of emergency medicine and intensive care consultants [J]. Emerg Med J, 2014, 31(12): 1000-1005.
30
Spyridaki A, Raftogiannis M, Antonopoulou A, et al. Effect of elarithromycin in inflammatory inarkers of patients with ventilator-associated pneumonia and sepsis caused by gram-negative bacteria: Results from a randomized clinical study [J]. Antimicrob Agents Chemother, 2012, 56(7): 3819-3825.
31
Savva A, Kanni T, Damoraki G, et al. Impact of toll-like receptor-4 and turnout necrosis factor gene polymorphisms in patients with hidradenitis suppurativa [J]. Br J Dermatol, 2013, 168(2): 311-317.
32
肖桂珍, 李俊, 苏磊. 危重患者的精准营养 [J]. 中华危重病急救医学, 2017, 29(11): 1052-1056.
33
Committee on a Framework for Development a New Taxonomy of Disease, National Research Council. Toward precision medicine: building a knowledge network for biomedical research and a new taxonomy of disease [M]. National Academies Press (US), 2011.
34
Kris MG, Johnson BE, Berry LD, et al. Using multiplexed assays of oncogenic drivers in lung cancers to select targeted drugs [J]. JAMA. 2014, 311(19): 1998-2006.
[1] 林丽, 杨英, 张毅. 精准医学时代乳腺癌腋窝淋巴结的管理[J/OL]. 中华乳腺病杂志(电子版), 2024, 18(04): 193-198.
[2] 庄燕, 戴林峰, 张海东, 陈秋华, 聂清芳. 脓毒症患者早期生存影响因素及Cox 风险预测模型构建[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(05): 372-378.
[3] 杨瑾, 刘雪克, 张媛媛, 金钧, 韦瑶. 肠道微生物来源石胆酸对脓毒症相关肝损伤的保护作用[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(04): 265-274.
[4] 张霞, 张瑞, 郑志波, 张勤. 紫草素调控乳酸化修饰和线粒体功能改善脓毒症心肌病小鼠的预后[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(04): 275-284.
[5] 张婧琦, 江洋, 孙佳璐, 唐兴喆, 赵宇飞, 崔颖, 李信响, 戴景月, 傅琳, 彭新桂. 基于肾周CT特征结合血清肌酐水平探讨脓毒症伴急性肾损伤的早期识别[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(04): 285-292.
[6] 李振翮, 魏长青, 甄国栋, 李振富. 脓毒症并发急性呼吸窘迫综合征患者血清S1P、Wnt5a变化及其临床意义[J/OL]. 中华危重症医学杂志(电子版), 2024, 17(04): 293-300.
[7] 曾德荣, 马琳, 李星瀚, 胡伟涛, 刘琦, 邓永强. 多聚ADP核糖聚合酶1在口腔鳞状细胞癌精准诊疗中的作用机制及转化价值[J/OL]. 中华口腔医学研究杂志(电子版), 2024, 18(04): 269-275.
[8] 陈曦, 吴宗盛, 郑明珠, 邱海波. 胸腺萎缩在脓毒症免疫紊乱中的研究进展[J/OL]. 中华重症医学电子杂志, 2024, 10(04): 379-383.
[9] 杨翔, 郭兰骐, 谢剑锋, 邱海波. 转录组学在脓毒症诊疗中的临床研究进展[J/OL]. 中华重症医学电子杂志, 2024, 10(04): 384-388.
[10] 成人脓毒症患者β-内酰胺类抗生素延长输注专家共识编写组. 成人脓毒症患者β-内酰胺类抗生素延长输注专家共识[J/OL]. 中华重症医学电子杂志, 2024, 10(04): 313-324.
[11] 胡梓菡, 彭菲, 孙骎, 杨毅. 细胞外囊泡在脓毒症血管内皮损伤作用中的研究进展[J/OL]. 中华重症医学电子杂志, 2024, 10(03): 265-270.
[12] 刘娟丽, 马四清, 乌仁塔娜. 髓源性抑制细胞在脓毒症中的研究进展[J/OL]. 中华重症医学电子杂志, 2024, 10(03): 271-278.
[13] 陈惠英, 邱敏珊, 邵汉权. 脓毒症诱发肠黏膜屏障功能损伤的风险因素模型构建与应用效果[J/OL]. 中华消化病与影像杂志(电子版), 2024, 14(05): 448-452.
[14] 傅新露, 李之岳, 卢丹. 妊娠合并结肠癌穿孔致脓毒症休克一例并文献复习[J/OL]. 中华产科急救电子杂志, 2024, 13(04): 227-231.
[15] 席静妮, 李娜, 张琪. 中性粒细胞与淋巴细胞比值对老年重症社区获得性肺炎进展为脓毒症的预测价值[J/OL]. 中华老年病研究电子杂志, 2024, 11(03): 28-31.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?