脓毒症肝损伤发生机制研究进展

Progress in the Pathogenesis of Liver Injury in Sepsis

肝损伤在脓毒症的发生、发展中起重要作用,而改善肝功能有助于改善患者预后,因此研究脓毒症肝损伤发生机制有重要的临床价值。目前其发生机制进展如下:脓毒症引起肝微循环与肝血流改变导致肝细胞缺血缺氧,在此基础上合并有肝细胞的能量代谢障碍同时引起肝功能损伤,内毒素直接对库普弗细胞的损伤作用,同时内毒素可引起炎性因子的变化加重对肝功能造成损伤,脓毒症时氧自由基的大量释放和脂质过氧化产物丙二醛的毒性作用引起肝细胞膜和线粒体膜完整性的破坏,引起肝功能损伤,血小板活化因子的作用,肝细胞凋亡,以及其他一些肝损伤的发生机制共同引起脓毒症时肝损伤。该文就以上脓毒症肝损伤发生机制予以综述。

Liver injury plays an important role in the development of sepsis,and improving liver function helps to improve the prognosis of patients.Therefore,the pathogenesis of liver injury in sepsis research has important clinical value.The current study suggests that the pathogenesis of septic liver is as follows：sepsis caused hepatic microcirculation and hepatic blood flow changes lead to hypoxic-ischemic liver cells,and if combined energy metabolism of liver cells exists,liver injury is then caused.Endotoxin directly damages Kupffer cells,while the endotoxin can cause inflammatory cytokines changes which aggravates the liver injury.The massive release of oxygen free radicals and lipid peroxidation product malondialdehyde in sepsis cause damage to the integrity of mitochondrial membrane and cell membranes,causing liver injury.The role of platelet activating factor,hepatocyte apoptosis,and some other processes together cause the liver injury in sepsis,and here is to make a review of the above mentioned mechanisms of septic liver injury.