长期以来,人们对于严重创伤、烧伤后机体免疫功能紊乱的确切机制及其在脓毒症中的作用认识不足,临床上缺乏切实有效的免疫功能监测手段和调理措施.近年来的研究证实,机体免疫功能障碍参与了脓毒症的病理生理过程,其中神经-内分泌-免疫功能网络紊乱理论尤其值得关注.对机体免疫状况进行监测具有重要意义,其中动态监测单核细胞人白细胞抗原(HLA)-DR的定量表达有助于临床更精确地了解危重患者的免疫功能状态并判断其预后.%Sepsis and related syndromes are the major cause of multiple organ failure and even death in patients following acute insults, including massive hemorrhage, trauma and burns.An overwhelming systemic inflammation has long been thought to be an important event in the development of sepsis, however, immunomodulatory agents and monitoring of immune dysfunction which has been proven clinically applicable and safe, has not available in septic settings.Recent studies have demonstrated that impairment of immune functions is critically involved in the pathogenesis of sepsis, in which dissonance of neuro-endocrine-immune axis appears to contribute to this process.Major burns and traumatic injury can result in marked dysregulation of host immune response.Quantitative measurement of human leukocyte antigen DR expression on CD14+ mononuclear cell surface might be of significance in forecasting development of severe sepsis and prognosis in critically ill patients.
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