肝細胞のミトコンドリアの超構造と機能の保護は,重症患者のインスリンによる厳格な血糖コントロールによって行われます
Ilse Vanhorebeek1, Rita De Vos, Dieter Mesotten
1Departments of Intensive Care Medicine, Catholic University of Leuven, B-3000 Leuven, Belgium.
Lancet (London, England)
|January 11, 2005
まとめ
集中インスリン療法により,重症患者の肝臓ミトコンドリアの構造と機能が改善され,血糖のコントロールが重要なことを示唆しています. これは,死亡率を減らすためにインセンティブ・インスリン療法を使用することを支持しています.
科学分野:
- クリティカルケア医療は,重症治療薬です.
- ミトコンドリア生物学 ミトコンドリア生物学
- メタボリック障害 メタボリック障害
背景:
- 外科重症室でのインスリン療法による集中治療は,罹病率と死亡率を低下させる.
- ミトコンドリア機能不全は,重篤な病気や糖尿病に関与しています.
- 集中インスリン療法の治療上の利点には,ミトコンドリアの完全性が含まれている可能性があります.
研究 の 目的:
- 重症患者のミトコンドリア構造と機能に対するインセンティブインスリン療法の影響を調査する.
- 厳格な血糖コントロールが肝細胞と骨格筋ミトコンドリアに影響するかどうかを判断する.
主な方法:
- 呼吸器連鎖複合体とGAPDHの酵素活動は,肝臓と骨格筋のサンプルで測定されました.
- ミトコンドリアの超構造は電子顕微鏡を用いて調べられました.
- 患者はランダムに集中型 (ノルモグリケミア) または従来の (ハイパーグリケミア) インスリン療法に割り当てられました.
主要な成果:
- 集中インスリン療法により,肝臓のミトコンドリア形態の異常を予防または逆転させました.
- 集中治療群の肝細胞ミトコンドリアは,呼吸器連鎖複合体IとIVの活性性が高かった.
- 骨格筋のミトコンドリアの構造と機能は,集中インスリン療法によって影響を受けませんでした.
結論:
- インスリン療法による厳格な血糖コントロールは,肝細胞のミトコンドリアの完全性を保ちます.
- インスリン自体ではなく,グルコースの毒性は,肝臓ミトコンドリアに対する観察された影響を説明する可能性がある.
- ミトコンドリア機能の回復は,重症患者の潜在的な治療目標です.
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