摘要持续炎症-免疫抑制-分解代谢综合征(PICS)在多器官功能衰竭(MOF)的概念上进一步拓展,反映出机体促炎反应对抗炎反应的优势逐渐被逆转,形成了持续低水平的炎症状态和严重的免疫抑制状态.虽然重症抢救管理技术的发展使危重患者的早期存活率显著提高,但大部分患者的晚期预后仍不容乐观.PICS防治困难、晚期病死率高,且发病率逐年上升,是重症加强治疗病房(ICU)面临的重要挑战.通过梳理对PICS的认识、总结PICS各免疫环节的特征性变化,探索具备PICS早期识别和免疫状态判断潜力的指标,为PICS防治提供新的思路.

abstractsTerminology of persistent inflammation immunosuppression and catabolism syndrome (PICS) is developed based on the concept of multiple organ failure (MOF), which reflect that the preponderance is gradually reversed from pro-inflammation to anti-inflammation, and eventually the state of simultaneously persistent inflammation and severe immunosuppression appeared. Although the improvement of rescue technology and management increase the early survival rates of patient with critical illnesses, the long-term outcomes of most patients are not optimistic. The patients with PICS are difficult to treat or prevent, and are likely to indolent death and have a rising incidence, which is an important challenge to the intensive care unit (ICU). The paper review the understanding of PICS, summarize the specific changes of immune system in PICS, and explore the immunological markers for early recognition of PICS and judgment of immune state in order to provide new thinking for prevention and control of PICS.