セプシスと心臓の関係
1Department of Medicine, RWTH Aachen University, Aachen, Germany. mmerx@ukaachen.de
Circulation
|August 19, 2007
まとめ
セプシスは,不適切な免疫反応による心臓機能不全を引き起こし,全身性不血症ではない. 研究では,心筋の抑うつ因子と,結核ショックにおける内皮活性化について調べています.
科学分野:
- 心臓病学 心臓病学
- 免疫学 免疫学とは
- クリティカルケア・メディシン
背景:
- セプシスはしばしば心血管系に影響を及ぼし,心筋機能不全とセプシスショックを引き起こす.
- 50年以上にわたる研究により,心不全によるセプシス症候群が調査されていますが,正確な原因は未だに不明です.
- グローバル・イシュケミアは主要な原因ではありませんが,冠動脈疾患は地域的な問題を早急に引き起こします.
研究 の 目的:
- セプティック心筋機能不全を特徴付けるために.
- セプシス中の心臓機能不全の根底にある提案されたメカニズムを評価する.
- セプティック心筋病症の現在のおよび将来の治療戦略をレビューする.
主な方法:
- このレビューは,既存の臨床的および基礎研究成果をまとめています.
- サイトカイン,プロスタノイド,酸化窒素などの提案されたメディエーターを調べています.
- 内皮の活性化と凝固の病理生理学的貢献が論じられている.
主要な成果:
- セプティック心筋機能障害は,免疫反応の影響を受ける複雑な状態です.
- 潜在的に循環する心筋収縮因子と内皮/凝固系活性化が関与している.
- 現在の主な治療法は,抗生物質と源のコントロールを伴うもので,重篤な症例ではサポートケアが不可欠である.
結論:
- セプティック心筋機能障害のメカニズムを理解することは,患者のアウトカムを改善するために非常に重要です.
- 炎症メディエーターと内皮機能不全を標的とした治療は,将来の治療方法を提供することができる.
- 原因療法と補助療法を組み合わせた多面的なアプローチは,セプティック心筋病症の管理に不可欠です.
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