创伤及感染时GH-IGF-IGFBP轴的变化及其临床意义

Changes in the GH-IGF-IGFBP axis in traumatic and septic patients and its clinical significance

创伤和感染病人往往存在高分解代谢 ,包括蛋白质合成减少、分解增加 ,形成明显的负氮平衡。如何逆转高分解反应曾经过漫长的探索。除了营养支持外 ,人们希望通过抗分解激素减轻甚至是逆转高分解状态。新近研究提示 ,在基础和应激条件下 ,生长激素 胰岛素样生长因子 胰岛素样生长因子结合蛋白 (GH IGF IGFBP)轴对调节肌肉蛋白质代谢起着核心作用。

Increased catabolism, including reduced protein synthesis rates and increased protein degration rates, is common in patient with trauma and sepsis. There has been a long time search in how to reverse the increased catabolism. Besides nutritional support, people hope manipulation of anti catabolism hormone might reverse or at least ameliorate catabolism. Recent researches indicate that the GH IGF IGFBP axis plays a crucial part in regulating the metabolism of muscle protein on both basal and stress condition. This article aims to review the changes in GH IGF IGFBP axis and its clinical significance associated with trauma and sepsis.