ミトコンドリア機能不全と септикショックの重症度および結果との関連
David Brealey1, Michael Brand, Iain Hargreaves
1Bloomsbury Institute of Intensive Care Medicine, Wolfson Institute of Biomedical Research and Department of Medicine, University College London, London W1T 3AA, UK.
Lancet (London, England)
|July 23, 2002
まとめ
セプシスはミトコンドリア機能障害とATPレベルが低下し,臓器不全と不良の結果に関連しています. 酸化窒素の過剰生産と抗酸化物質の枯渇は,重症患者のこのバイオエネルギー障害に寄与する.
科学分野:
- クリティカルケア・メディシン
- バイオケミストリー バイオケミストリー
- 病理生理学 病理生理学とは
背景:
- セプシス誘発の多臓器不全は,重症患者の主要な死因です.
- セプシスにおける臓器機能障害のメカニズムは完全に理解されていません.
- セプシスにおける組織酸素濃度の上昇は,ミトコンドリア機能障害による可能性のある酸素利用の障害を示唆する.
研究 の 目的:
- セプシス誘発の臓器不全におけるミトコンドリア機能障害の役割を調査する.
- セプティック症患者における酸化窒素生成,抗酸化状態,ミトコンドリア機能の関連性を調査する.
主な方法:
- 骨格筋バイオプシは,28人の重症のセプティック患者と9人の健康な対照群で実施されました.
- 分析には,呼吸器連鎖酵素活性 (複合体I-IV),ATP濃度,減少グルタチオン,およびニートリート/ニートレートのレベルが含まれていました.
主要な成果:
- 死んだセプティック症の患者は,生存者と対照群よりも骨格筋のATP濃度が著しく低かった.
- 複合体Iの活性度は,衝撃の重度と酸化窒素マーカーと逆相関し,グルタチオンとATPのレベル低下と正相関していた.
結論:
- 酸化窒素の過剰生産,抗酸化物質の枯渇,ミトコンドリア機能障害,そしてセプティック症患者のATPの減少との間には関連がある.
- これらの要因は,臓器不全と患者のアウトカムと相関しています.
- バイオエネルギー機能不全は,セプシス誘発の多臓器機能不全の重要なメカニズムとして関与しています.
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