脓毒症对心脏物质代谢的影响机制研究进展  

Research progress of the effects of sepsis on cardiac substance metabolism

作　　者：姜焕玲[1] 范树信[2] 王芳[3] JIANG Huanling;FAN Shuxin;WANG Fang(Department of Emergency,University of Health and Rehabilitation Sciences(Qingdao Municipal Hospital),Shandong,Qingdao 266300,China;不详)

机构地区：[1]康复大学青岛医院(青岛市市立医院)急诊科,山东省青岛市266300 [2]康复大学青岛医院(青岛市市立医院)心内科,山东省青岛市266300 [3]山东省青岛市第三人民医院心内一科

出　　处：《河北医药》2023年第5期766-770,共5页Hebei Medical Journal

基　　金：青岛市医药科研指导计划(编号:2019-WJZD092)。

摘　　要：脓毒症疾病进展迅速,及时诊断和治疗对患者预后至关重要。尽管近年来对于脓毒症的研究和认知取得了长足进步,但对于脓毒症引起的心肌病(sepsis-induced cardiomyopathy,SICM)尚无有效的治疗方法。SICM机制与心肌缺血的发生机制不同。在脓毒症中,内毒素、细胞因子和一氧化氮等化学介质会导致心肌细胞代谢异常、线粒体功能障碍和β-肾上腺素能受体的下调。这些因素可抑制心肌细胞内ATP的产生,而导致心脏功能和结构障碍。本综述侧重脓毒症发生后心脏的脂质、糖类、酮体、氨基酸和线粒体代谢变化特点。除对线粒体代谢炎症管理外,以代谢为重点的干预措施可能成为SICM治疗新策略。Sepsis progresses rapidly.Timely diagnosis and treatment are very important for the prognosis of patients.Although great progress has been made in the research and cognition of sepsis in recent years,there is no effective treatment method for sepsis induced cardiomyopathy(SICM).The mechanism of SICM is different from that of myocardial ischemia.In sepsis,chemical mediators including endotoxin,cytokines and nitric oxide can result in cardiomyocyte metabolic abnormalities,mitochondrial dysfunction and apoptosisβ-downregulation of adrenergic receptors.These factors can inhibit the production of ATP in cardiomyocytes,resulting in cardiac function and structural disorders.This review focuses on the metabolic changes of lipids,carbohydrates,ketones,amino acids and mitochondria in the heart after sepsis.In addition to the management of mitochondrial metabolic inflammation,interventions focusing on metabolism may become a new strategy for the treatment of SICM.

关 键 词：脓毒症 脓毒症引起的心肌病 物质代谢 Β-肾上腺素受体 

分 类 号：R459.7[医药卫生—急诊医学]