Toxic Shock Syndrome Major Advances in Pathogenesis, But Not Treatment
Toxic Shock Syndrome Major Advances in Pathogenesis, But Not Treatment
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DOI：
10.1016/j.ccc.2013.03.012
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发表时间：
2013-07-01
影响因子：
4.3
通讯作者：
Low, Donald E.
中科院分区：
文献类型：
--
作者：
Low, Donald E.
中毒性休克综合征（TSS）主要是超抗原介导的细胞因子风暴和M蛋白介导的中性粒细胞活化的结果，导致介质的释放导致呼吸衰竭、血管渗漏和休克。链球菌TSS的死亡率仍然徘徊在50%。有证据支持静脉注射免疫球蛋白（IVIG）在链球菌性TSS治疗中的作用。一项观察性研究表明，对于血流动力学不稳定的患者，最初的保守手术方法结合免疫调节剂（如IVIG）的使用，可能会降低与广泛手术探查相关的发病率，而不会增加死亡率。
Toxic shock syndrome (TSS) is primarily the result of a superantigen-mediated cytokine storm and M protein-mediated neutrophil activation, resulting in the release of mediators leading to respiratory failure, vascular leakage, and shock. Mortality for streptococcal TSS still hovers at 50%. There is evidence to support a role for intravenous immunoglobulin (IVIG) in the treatment of streptococcal TSS. An observational study suggests that an initial conservative surgical approach combined with the use of immune modulators, such as IVIG, may reduce the morbidity associated with extensive surgical exploration in hemodynamically unstable patients without increasing mortality.