基于线粒体靶点对脓毒症心肌损伤的治疗

Mitochondrial target therapy for sepsis-induced myocardial dysfunction

脓毒症心肌损伤是脓毒症或脓毒症休克导致的急性器官损伤,以左(右)心室收缩、舒张泵功能受损为特征。尽管经过积极的抗感染、代谢复苏和多器官功能维护,有一部分脓毒症患者在心脏前负荷恢复后,其血流动力学仍然表现为低排高阻(周围血管阻力增加而心排血量降低),归根结底可能是因为心肌线粒体损伤还未恢复。微循环和线粒体的双重作用现在已成为脓毒症心肌损伤的研究热点。而线粒体作为脓毒症心肌损伤病理生理的中心参与者,其结构、数量和功能受损直接影响着脓毒症患者的存活率和预后。该综述主要介绍了以线粒体为靶点的治疗在脓毒症心肌损伤中的作用,研究线粒体靶向治疗脓毒症心肌损伤具有良好的治疗前景。

Sepsis-induced myocardial dysfunction is an acute organ injury resulting from sepsis or septic shock,characterized by left(right)ventricular contraction and impaired diastolic pump function.Despite after the active anti-infection,aggressive fluid resuscitation and multi-organ protection,despite cardiac preload have recovered,a proportion of patients with sepsis return to cardiac preload,hemodynamics of some sepsis patients still show low-output and high-resistance(increased peripheral vascular resistance and decreased cardiac output),which may be attributed to the fact that the myocardial mitochondrial damage has not been recovered.The dual role of microcirculation and mitochondria has become a hotspot in the study of sepsisinduced myocardial dysfunction.Mitochondria are central participants in the pathophysiology of sepsisinduced myocardial dysfunction,and mitochondrial structure,quantity and function impairment directly affect the survival rate and prognosis of patients with sepsis.This review mainly introduces the role of mitochondrial targeted therapy in sepsis-induced myocardial dysfunction,and studies on mitochondrial targeted therapy indicate a new therapeutic prospect and even specific prevention strategies for sepsis-induced myocardial dysfunction.