脓毒症时心肌能量代谢障碍机制的研究进展
| 作者: |
1杨柳,
1张芬,
1王慷慨,
1王念,
1肖献忠
1 中南大学基础医学院病理生理学系，长沙 410078 |
| 通讯: |
王念
Email: csuwangnian@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2016.08.032 |
| 基金: | 国家自然科学基金, 81000846 湖南省自然科学基金, 12JJ4084 |
摘要
心肌能量代谢障碍是导致脓毒症时心肌损伤的重要因素，但其确切的机制目前尚未完全阐明。正常情况下，线粒体是心肌能量代谢的主要场所，脂肪酸和葡萄糖氧化代谢生成的三磷酸腺苷是心脏能量的主要来源。脓毒症时，线粒体结构损伤、呼吸功能障碍、Ca2+超载、生物合成改变、自噬以及脂肪酸摄取、转运、氧化减少和葡萄糖代谢异常等导致了心肌能量代谢障碍，进而引起心肌结构损伤和功能障碍。本文主要对线粒体结构和功能异常、糖脂质代谢紊乱与脓毒症心肌能量代谢障碍关系的研究进展进行了综述。
关键词：
脓毒症
心肌
能量代谢
线粒体
脂肪酸氧化
Research progress of the mechanism of myocardial energy metabolism disorder in sepsis
CorrespondingAuthor: WANG Nian Email: csuwangnian@163.com
DOI: 10.3978/j.issn.2095-6959.2016.08.032
Abstract
Myocardial energy metabolism disorder is the main cause leading to myocardial injury in sepsis. Nevertheless, the precise pathogenesis still remains incompletely elucidated. Normally, mitochondria are the main site of myocardial energy metabolism. Adenosine triphosphate produced from the oxidative metabolism of fatty acids and glucose provides the myocardial energy. In sepsis, mitochondrial structural damage, respiratory dysfunction, calcium overload, biogenetic changes, mitophagy, reduction of fatty acid uptake, transport and oxidation as well as the depression of glucose oxidation are involved in the myocardial energy metabolism disorder, which further induce the myocardial structural damage and dysfunction. The research progress of the relationship among mitochondrial damage, lipid and glucose metabolism disturbance and myocardial energy metabolism disorder are mainly reviewed in this article.