脓毒症心肌损伤病理生理研究进展

Progress in pathophysiology of myocardial injury in sepsis

脓毒症是常见的临床疾病之一,因其高发病率和高死亡率得到越来越多的关注。脓毒症累及多器官功能损害,心肌功能障碍则是脓毒症患者最常见的并发症之一。脓毒症心肌损伤的发病机制可能是代谢、细胞凋亡、神经免疫调节等多项因素相互作用的综合结果,心肌抑制因子、自主神经失调、心肌细胞钙离子转运蛋白的功能紊乱、心肌能量代谢障碍、细胞凋亡等参与其中。阐明这些机制将有助于识别脓毒症心肌功能障碍并提高脓毒症患者的治疗水平。

Sepsis is one of the common clinical diseases, and it is receiving more and more attention due to its high incidence rate and high mortality. Sepsis is easy to cause multiple organ involvement, and myocardial dysfunction is one of the most common complications in patients with sepsis. Sepsis myocardial inhibition is a left and right heart contraction and diastolic dysfunction caused by sepsis, which is closely related to the increase in mortality in patients with sepsis. The pathophysiological pathogenesis of sepsis myocardial injury may be the result of a combination of factors such as metabolism, apoptosis, and neuroimmunomodulation. Myocardial inhibitory factor, autonomic dysfunction, dysfunction of cardiomyocyte calcium ion transporter, myocardial energy metabolism disorder, and apoptosis are involved. Elucidation of these mechanisms will help identify sepsis heart dysfunction and improve the treatment of patients with sepsis.