脓毒血症所致心肌损伤的发生机制与相关标志物的研究进展  

Research progress on the pathogenesis and related markers of myocardial injury caused by sepsis

作　　者：梁伟明 LIANG Wei-ming(Shunde District First People's Hospital,Foshan 528300,China)

机构地区：[1]佛山市顺德区第一人民医院,528300

出　　处：《中国现代药物应用》2023年第8期166-169,共4页Chinese Journal of Modern Drug Application

摘　　要：脓毒血症是一种由常见细菌、病毒或真菌感染机体组织或器官而引发炎症反应的较为复杂的常见临床综合征。该疾病的死亡率已超过心肌梗死,成为临床上治疗困难程度最大、费用最高以及资源需求最高的疾病之一。本文通过查找相关文献总结了该疾病的病理生理机制,主要包括线粒体代谢障碍、分子表达水平发生改变、细胞凋亡增加等。目前,关于脓毒血症所致心肌损伤的诊断暂无统一化标准,主要通过患者的心率表现、心脏彩超以及心肌损伤生物标志物等进行综合判断。本文总结归纳了临床常用敏感性相对较高、特异性相对较强的生物标志物,包括心肌肌钙蛋白(cTn)、脑钠肽(BNP)与N末端BNP前体(NT-proBNP)、心型脂肪酸结合蛋白(H-FABP)等,此类物质的释放可反映脓毒血症所致心肌损伤的程度,帮助判断患者预后情况及术后治疗方向。Sepsis is a complex common clinical syndrome caused by common bacteria,viruses or fungi infecting body tissues or organs and causing inflammatory responses.The mortality rate of this disease has surpassed myocardial infarction as one of the most difficult to treat,the most expensive and the most resourcedemanding diseases in the clinic.This article summarizes the pathophysiological mechanism of the disease by finding relevant literature,mainly including mitochondrial metabolism disorders,changes in molecular expression levels,and increased apoptosis.At present,there is no unified standard for the diagnosis of myocardial injury caused by sepsis,and it is mainly judged by the patient's heart rate performance,cardiac ultrasound and myocardial injury biomarkers.This article summarizes biomarkers with relatively high sensitivity and specificity,including cardiac troponin(cTn),brain natriuretic peptide(BNP),N-terminal pro-brain natriuretic peptide(NTproBNP),and heart-type fatty acid-binding protein(H-FABP).The release of these substances reflects the extent of myocardial damage due to sepsis,helping to determine the patient's prognosis and postoperative treatment direction.

关 键 词：脓毒血症 心肌损伤 病理机制 标志物 

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