脓毒性心肌病的发病机制及治疗  

Pathogenesis and treatment of septic cardiomyopathy

作　　者：胡青 曹小平[1] 黄钲 谢明欣 于任轩 王家珍 HU Qing;CAO Xiaoping;HUANG Zheng;XIE Mingxin;YU Renxuan;WANG Jiazhen(Department of Emergency Medicine,Affiliated Hospital of North Sichuan Medical College,Nanchong,Sichuan 637000,P.R.China;Department of Critical Care Medicine,Santai Hospital,North Sichuan Medical College,Santai,Sichuan 621100,P.R.China)

机构地区：[1]川北医学院附属医院急诊医学科,四川南充637300 [2]川北医学院附属三台医院重症医学科,四川三台621100

出　　处：《华西医学》2020年第11期1380-1385,共6页West China Medical Journal

基　　金：四川省医学会重症医学专项科研课题(2015ZZ006)。

摘　　要：脓毒症是严重创伤、感染、休克及大手术后常见的并发症,具有发病率高、病死率高及住院费用高的特点。而脓毒性心肌病是脓毒症患者死亡的主要原因之一。该文就脓毒性心肌病的发病机制及治疗进行综述,其发病机制包括血流动力学及心肌改变、线粒体裂变、心肌细胞凋亡和自噬、钙离子失衡、炎性机制和免疫调节机制,其治疗包括常规治疗、β1受体阻滞剂治疗、褪黑激素、5-羟色胺3受体拮抗剂、右美托咪定和中医治疗等,旨在为脓毒性心肌病的诊治提供参考。Sepsis is a common complication after severe trauma,infection,shock and major surgery.It has the characteristics of high morbidity,high mortality,and high hospitalization costs.Septic cardiomyopathy is one of the main causes of death in patients with sepsis.This article reviews the pathogenesis and treatment of septic cardiomyopathy.The pathogenesis includes hemodynamics and myocardial changes,mitochondrial fission,cardiomyocyte apoptosis and autophagy,calcium ion imbalance,inflammation mechanism and immune regulation mechanism.The treatment includes conventional treatment,β1 receptor blocker treatment,melatonin,serotonin 3 receptor antagonist,dexmedetomidine and traditional Chinese medicine treatment,etc.,aiming to provide a reference for the diagnosis and treatment of septic cardiomyopathy.

关 键 词：脓毒症 心肌病 发病机制 治疗 

分 类 号：R459.7[医药卫生—急诊医学] R542.2[医药卫生—治疗学]