脓毒症心功能障碍的定义及其生物标志物研究进展
Definition of Sepsis-Induced Myocardial Dysfunction and Research Progress of Its Biomarkers
DOI: 10.12677/acm.2025.153756, PDF,    科研立项经费支持
作者: 张 锦：西安医学院研究生工作部，陕西 西安；空军军医大学唐都医院感染科，陕西 西安；连建奇, 姜 泓, 杜 虹*：空军军医大学唐都医院感染科，陕西 西安；李锐成：空军军医大学唐都医院检验科，陕西 西安；余登辉：空军军医大学唐都医院感染科，陕西 西安；南部战区总医院重症医学科，广东 广州；卫艳锋：空军军医大学唐都医院感染科，陕西 西安；延安大学医学院，陕西 延安
关键词: 脓毒症心功能障碍；定义；预测；生物标志物；Sepsis-Induced Myocardial Dysfunction； Definition； Prediction； Biomarkers
摘要: 脓毒症是指宿主对感染的反应失调，进而导致危及生命的器官功能障碍。脓毒症病程中常出现一种可逆的心功能障碍，即脓毒症心功能障碍(sepsis-induced myocardial dysfunction, SIMD)。心脏超声的应用提高了对心脏功能的实时动态评估，但也在一定程度上增加了对SIMD精准定义的不确定性。此外，SIMD的早期识别预警对指导临床救治具有重要意义，然而，传统的心肌损伤标志物，如B型脑钠肽、心肌肌钙蛋白等在SIMD的预测方面仍缺乏特异性。基于此，本文讨论了SIMD的定义变迁及不足，描述了SIMD的主要特征及临床表型，并简要介绍了miRNA、高迁移率族蛋白B1、H-FABP、TREM-1、PAPPA等新型生物标志物在SIMD诊断及预测中的价值，为SIMD的预警诊治提供新见解。
Abstract: Sepsis is a dysregulated host response to infection, resulting in life-threatening organ dysfunction. A reversible cardiac dysfunction often occurs during the course of sepsis, namely sepsis-induced myocardial dysfunction (SIMD). The application of cardiac ultrasound improves the real-time dynamic assessment of cardiac function, but it also increases the uncertainty of the precise definition of SIMD to a certain extent. In addition, early identification and warning of SIMD is of great significance in guiding clinical treatment. However, traditional myocardial injury markers, such as B-type brain natriuretic peptide and cardiac troponin, still lack specificity in predicting SIMD. Based on this, this article discusses the changes and deficiencies in the definition of SIMD, describes the main characteristics and clinical phenotypes of SIMD, and briefly introduces the value of new biomarkers, such as miRNA, high mobility group protein B1, H-FABP, TREM-1, and PAPPA, in the diagnosis and prediction of SIMD, providing new insights into the early warning diagnosis and treatment of SIMD.
文章引用：张锦, 连建奇, 李锐成, 姜泓, 余登辉, 卫艳锋, 杜虹. 脓毒症心功能障碍的定义及其生物标志物研究进展[J]. 临床医学进展, 2025, 15(3): 1405-1414. https://doi.org/10.12677/acm.2025.153756

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