严重损伤,不论其原因为重大事故、大面积烧伤或复杂外科手术,常导致脓毒症。此时特异性和非特性宿主防御系统二者均受影响。应予注意的方面主要有趋化性、吞噬作用、细胞内杀死、补体消耗和体液及细胞介导的免疫抑制。细胞介导免疫发生的变化最大。损伤后数小时内,循环T细胞数大量消耗,胸导管淋巴细胞明显减少。改变不仅在数量上,也发生在功能上。防御机制方面这些缺陷的临床重要性在于:低毒力微生物对受伤者可能成为致死的威胁。当今,正在进行研究,以期通过免疫治疗使这些缺陷得到逆转。 Serious injury, whether due to a major accident, extensive burns or complex surgical procedures, often leads to sepsis. Both the specific and non-specific host defense systems are affected at this time. Key aspects to note are chemotaxis, phagocytosis, intracellular killing, complement depletion, and humoral and cell-mediated immunosuppression. Cell-mediated immune changes occur the most. Within a few hours after injury, a large number of circulating T cells were consumed, and thoracic ductal lymphocytes were significantly reduced. Changes occur not only in quantity but also in function. The clinical importance of these deficiencies in defense mechanisms lies in the fact that low virulent microorganisms can be a lethal threat to the wounded. Nowadays, research is under way to reverse these defects through immunotherapy.