脓毒症免疫抑制中B淋巴细胞亚群的变化 与预后关系的研究进展
Research Progress on Changes of B Lymphocyte Subsets and Their Relationship with Prognosis in Sepsis-Induced Immunosuppression
DOI: 10.12677/acm.2026.1641470, PDF,   
作者: 陈卓越, 许 峰*：重庆医科大学附属儿童医院重症医学科，重庆
关键词: 脓毒症；免疫抑制；B淋巴细胞亚群；预后；Sepsis； Immunosuppression； B Lymphocyte Subsets； Prognosis
摘要: 脓毒症是感染引起的机体反应失调而导致的严重的危及生命的器官功能障碍，其病理机制复杂，免疫抑制已成为影响患者预后的关键因素。B淋巴细胞作为适应性免疫的重要组成部分，在脓毒症免疫抑制过程中表现出了显著的数量减少和功能改变，但其具体变化规律及临床意义尚待系统阐明。本文综述了脓毒症免疫抑制的概念演进与病理机制，重点阐述了B淋巴细胞及各亚群(包括过渡性B细胞、初始B细胞、记忆B细胞、抗体分泌细胞、双阴性B细胞及调节性B细胞等)在脓毒症中的数量与比例变化规律，并分析这些变化背后可能的病理生理机制。在此基础上，本文尝试探寻B细胞亚群变化与脓毒症患者预后的关联，探讨了其在预后预测中的潜在价值。最后，本文对B细胞免疫监测的研究方向进行了展望，以期为脓毒症预后监测提供新的思考。
Abstract: Sepsis is a life-threatening organ dysfunction caused by a dysregulated host response to infection. With a complex pathological mechanism, immunosuppression has become a key factor affecting the prognosis of patients. As a vital component of adaptive immunity, B lymphocytes exhibit significant quantitative reduction and functional alterations during the immunosuppressive process of sepsis, whereas their specific changing patterns and clinical significance remain to be systematically elucidated. This article reviews the conceptual evolution and pathological mechanisms of sepsis-induced immunosuppression, and focuses on elaborating the changing patterns of quantity and proportion of B lymphocytes and their various subsets (including transitional B cells, naïve B cells, memory B cells, antibody-secreting cells, double-negative B cells, regulatory B cells, etc.) in sepsis, as well as the potential pathophysiological mechanisms underlying these changes. On this basis, this article attempts to explore the association between changes in B-cell subsets and the prognosis of septic patients, and discusses their potential value in prognostic prediction. Finally, the research directions of B-cell immune monitoring are prospected, aiming to provide new insights for the prognostic monitoring of sepsis.
文章引用：陈卓越, 许峰. 脓毒症免疫抑制中B淋巴细胞亚群的变化 与预后关系的研究进展[J]. 临床医学进展, 2026, 16(4): 2224-2232. https://doi.org/10.12677/acm.2026.1641470

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