Pathophysiologie der Peritonitis

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• 作者：Dr. K. Beyer ; Dr. P. Menges ; Dr. W. Keßler ; Prof. Dr. C.-D. Heidecke
• 关键词：Peritonitis ; Sepsis ; Inflammation ; Apoptosis ; Immunosuppression
• 刊名：Der Chirurg
• 出版年：2016
• 出版时间：January 2016
• 年：2016
• 卷：87
• 期：1
• 页码：5-12
• 全文大小：708 KB
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• 作者单位：Dr. K. Beyer (1)
  Dr. P. Menges (1)
  Dr. W. Keßler (1)
  Prof. Dr. C.-D. Heidecke (1)
  
  1. Klinik für Chirurgie, Viszeral-, Thorax- und Gefäßchirurgie, Universitätsmedizin Greifswald, Ferdinand-Sauerbruch-Straße, 17475, Greifswald, Deutschland
  
• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Surgery
  Cardiac Surgery
  Pediatric Surgery
  Plastic Surgery
  Traumatic Surgery
  Vascular Surgery
  
• 出版者：Springer Berlin / Heidelberg
• ISSN：1433-0385

文摘

Despite intensive research efforts peritonitis leading to subsequent sepsis remains associated with a high mortality. The initial effector cells are the locally residing cells of the peritoneum, such as mesothelial cells, mast cells, macrophages and lymphocytes. Through the secretion of chemokines, an influx of neutrophils initially takes place followed by monocytes. The latter can differentiate into inflammatory macrophages. The non-directed activity of neutrophilic granulocytes is limited by the induction of apoptotic programs. Through the breaching of cytokines, bacteria and microbial products into the circulation, a systemic reaction in the sense of systemic inflammatory response syndrome (SIRS) or sepsis arises. This is viewed as a concomitant derailing of inflammatory as well as anti-inflammatory responses, which leads to extensive apoptosis of lymphocytes. The presentation of apoptotic cells leads to a strong immunosuppression. Due to the coexistence of hyperinflammation and immunosuppression, exact knowledge of the current immune status of the patient is a prerequisite in the development of immunotherapies for the treatment of sepsis.