儿童脓毒症与钙紊乱研究进展
Research Progress on Sepsis and Disorder of Calcium in Children
DOI: 10.12677/ACM.2023.134979, PDF,   
作者: 李凌霄, 李 静*：重庆医科大学附属儿童医院重症医学科，国家儿童健康与疾病临床医学研究中心，儿童发育疾病研究教育部重点实验室，儿科学重庆市重点实验室，重庆
关键词: 儿童；脓毒症；钙离子；钙通道阻滞剂；钙增敏剂；Children； Sepsis； Calcium； Calcium Channel Blocker； Calcium Sensitizer
摘要: 近些年来，学者们发现儿童脓毒症与钙紊乱存在紧密联系，比如作为第二信使介导炎症发生、细胞凋亡、代谢改变，进而引起重要脏器的损伤等，在这一系列过程中钙紊乱从多种途径参与了脓毒症的发生发展。目前临床上对于儿童脓毒症低钙血症是否予以积极补钙尚无相关共识，本文试图通过对近些年国内外关于脓毒症与钙紊乱相关文献的查阅总结，进而对临床脓毒症相关钙紊乱处理提供参考。
Abstract: In recent years, scholars have found a strong association between childhood sepsis and calcium disorders. For example, as a second messenger mediates inflammation, apoptosis, metabolic changes, and consequently damage to vital organs. In this series of processes calcium disorders are involved in the development of sepsis in multiple ways. However, there is no clinical consensus on whether to actively supplement calcium in children with sepsis hypocalcemia. Therefore, this paper attempts to summarize the recent literature on sepsis and calcium disorders at home and abroad, and then provide a reference for the clinical management of sepsis-related calcium disorders.
文章引用：李凌霄, 李静. 儿童脓毒症与钙紊乱研究进展[J]. 临床医学进展, 2023, 13(4): 6999-7005. https://doi.org/10.12677/ACM.2023.134979

参考文献

[1] Weiss, S.L., Peters, M.J., Alhazzani, W., et al. (2020) Surviving Sepsis Campaign International Guidelines for the Man-agement of Septic Shock and Sepsis-Associated Organ Dysfunction in Children. Pediatric Critical Care Medicine, 21, e52-e106. [Google Scholar] [CrossRef] 
[2] Dias, C.R.B., Leite, H.P., Nogueira, P.C.K. and de Carvalho, W.B. (2013) Ionized Hypocalcemia is an Early Event and is Associated with Organ Dysfunction in Children Admitted to the Intensive Care Unit. Journal of Critical Care, 28, 810-815. [Google Scholar] [CrossRef] [PubMed]
[3] Moyer, A.M., Saenger, A.K., Willrich, M., Donato, L.J., et al. (2016) Implementation of Clinical Decision Support Rules to Reduce Repeat Measurement of Serum Ionized Calcium, Serum Magnesium, and N-Terminal Pro-B-Type Natriuretic Peptide in Intensive Care Unit Inpatients. Clinical Chemis-try, 62, 824-830. [Google Scholar] [CrossRef] [PubMed]
[4] Li, H., Chen, J.J., Hu, Y.H., et al. (2022) Clinical Value of Se-rum Calcium in Elderly Patients with Sepsis. The American Journal of Emergency Medicine, 52, 208-211. [Google Scholar] [CrossRef] [PubMed]
[5] Liu, Y., Chai, Y., Rong, Z. and Chen, Y. (2020) Prognostic Value of Ionized Calcium Levels in Neonatal Sepsis. Annals of Nutrition and Metabolism, 76, 193-200. [Google Scholar] [CrossRef] [PubMed]
[6] D’Elia, J.A. and Weinrauch, L.A. (2018) Calcium Ion Channels: Roles in Infection and Sepsis Mechanisms of Calcium Channel Blocker Benefits in Immunocompromised Patients at Risk for In-fection. International Journal of Molecular Sciences, 19, Article No. 2465. [Google Scholar] [CrossRef] [PubMed]
[7] Yadav, S., Gupta, K., Deshmukh, K., et al. (2021) Calcium Sensing Receptor as a Novel Target for Treatment of Sepsis Induced Cardio-Renal Syndrome: Need for Exploring Mechanisms. Drug Development Research, 82, 305-308. [Google Scholar] [CrossRef] [PubMed]
[8] Wu, C.-L., Wu, Q.-Y., Du, J.-J., Zeng, J.-Y., et al. (2015) Calcium-Sensing Receptor in the T Lymphocyte Enhanced the Apoptosis and Cytokine Secretion in Sepsis. Molecular Immunology, 63, 337-342. [Google Scholar] [CrossRef] [PubMed]
[9] Cardenas-Rivero, N., Chernow, B., Stoiko, M.A., Nussbaum, S.R. and Todres, I.D. (1989) Hypocalcemia in Critically Ill Children. The Journal of Pediatrics, 114, 946-951. [Google Scholar] [CrossRef] 
[10] Mizock, B. (1984) Septic Shock: A Metabolic Perspective. Archives of Internal Medicine, 144, 579-585. [Google Scholar] [CrossRef] [PubMed]
[11] Schwartz, J.-L., Gameau, L., Masson, L. and Brousseau, R. (1991) Early Response of Cultured Lepidopteran Cells to Exposure to δ-Endotoxin from Bacillus thuringiensis: Involvement of Calcium and Anionic Channels. Biochimica et Biophysica Acta (BBA)-Biomembranes, 1065, 250-260. [Google Scholar] [CrossRef] [PubMed]
[12] Lorts, A., Burroughs, T. and Shanley, T.P. (2009) Elucidating the Role of Reversible Protein Phosphorylation in Sepsis-Induced Myocardial Dysfunction. Shock, 32, 49-54. [Google Scholar] [CrossRef] 
[13] Retzlaff, J., Thamm, K., Ghosh, C., et al. (2017) Flunarizine Suppresses Endothelial Angiopoietin-2 in a Calcium- Dependent Fashion in Sepsis. Scientific Reports, 7, Article No. 44113. [Google Scholar] [CrossRef] [PubMed]
[14] Behrends, M. and Peters, J. (2003) The Calcium Sensitizer Levosi-mendan Attenuates Endotoxin-Evoked Myocardial Dysfunction in Isolated Guinea Pig Hearts. Intensive Care Medicine, 29, 1802-1807. [Google Scholar] [CrossRef] [PubMed]
[15] Oldner, A., Konrad, D., Weitzberg, E., et al. (2001) Effects of Levosimendan, a Novel Inotropic Calcium-Sensitizing Drug, in Experimental Septic Shock. Critical Care Medicine, 29, 2185-2193. [Google Scholar] [CrossRef] [PubMed]
[16] McDonough, K.H., Lang, C.H. and Spitzer, J.J. (1985) Effect of Cardiotropic Agents on the Myocardial Dysfunction of Hyperdynamic Sepsis. Circulatory Shock, 17, 1-19.
[17] Williams, A.B., Decourten-Myers, G.M., Fischer, J.E., et al. (1999) Sepsis Stimulates Release of Myofila-ments in Skeletal Muscle by a Calcium-Dependent Mechanism. The FASEB Journal, 13, 1435-1443. [Google Scholar] [CrossRef] [PubMed]
[18] Steinhorn, D.M., Sweeney, M.F. and Layman, L.K. (1990) Phar-macodynamic Response to Ionized Calcium during Acute Sepsis. Critical Care Medicine, 18, 851-857. [Google Scholar] [CrossRef] [PubMed]
[19] Hwang, T.-L., Lau, Y.-T., Tsai, M.-M. and Liu, M.-S. (1997) Changes of Adenosine Triphosphate-Dependent Calcium Uptake in Microsomal Fractions of Rat Liver during Sepsis. Surgery, 121, 662-667. [Google Scholar] [CrossRef] 
[20] Parikh, S.M., Mammoto, T., Schultz, A., Yuan, H.T., Chris-tiani, D., Karamuchi, S.A. and Sukhatme, V.P. (2006) Excess Angiopoietin-2 May Contribute to Pulmonary Vascular Leak in Sepsis in Humans. PLOS Medicine, 3, e46. [Google Scholar] [CrossRef] [PubMed]
[21] David, S., Kümpers, P., van Slyke, P. and Parikh, S.M. (2013) Mending Leaky Blood Vessels: The Angiopoietin-Tie2 Pathway in Sepsis. Journal of Pharmacology and Experimental Therapeutics, 345, 2-6. [Google Scholar] [CrossRef] [PubMed]
[22] 杨喆, 黄斌, 林芬, 谢鹤, 陈潮青, 蔡燕杏, 吴建鹏, 林伟豪. 血清钙离子对小儿脓毒症及相关性弥散性血管内凝血的评估价值[J]. 齐齐哈尔医学学报, 2021, 42(12): 1013-1016. [Google Scholar] [CrossRef] 
[23] Zaloga, G.P., Sager, A., Black, K.W. and Prielipp, R. (1992) Low Dose Calcium Administration Increases Mortality during Septic Peritonitis in Rats. Circulatory Shock, 37, 226-229.
[24] Carlstedt, F, Eriksson, M, Kiiski, R., et al. (2000) Hypocalcemia during Porcine Endotoxemic Shock: Effects of Calcium Administration. Critical Care Medicine, 28, 2909-2914. [Google Scholar] [CrossRef] [PubMed]
[25] Weinrauch, L.A., D’Elia, J.A., Gleason, R.E., Shaffer, D. and Monaco, A.P. (1995) Role of Calcium Channel Blockers in Diabetic Renal Transplant Patients: Preliminary Ob-servations on Protection from Sepsis. Clinical Nephrology, 44, 185-192.
[26] Wiewel, M.A., van Vught, L.A., Sciclu-na, B.P., et al. (2017) Prior Use of Calcium Channel Blockers Is Associated with Decreased Mortality in Critically Ill Pa-tients with Sepsis: A Prospective Observational Study. Critical Care Medicine, 45, 454-463. [Google Scholar] [CrossRef] 
[27] Zheng, L., Hunter, K., Gaughan, J. and Poddar, S. (2017) Preadmission Use of Calcium Channel Blockers and Outcomes after Hospitalization with Pneumonia: A Retrospective Propensity-Matched Cohort Study. American Journal of Therapeutics, 24, e30-e38. [Google Scholar] [CrossRef] 
[28] Lee, C.-C., Lee, M.-T.G., Lee, W.-C., et al. (2017) Pread-mission Use of Calcium Channel Blocking Agents Is Associated with Improved Outcomes in Patients with Sepsis: A Population-Based Propensity Score-Matched Cohort Study. Critical Care Medicine, 45, 1500-1508. [Google Scholar] [CrossRef] 
[29] Ding, X.F., Cui, Y.Q., Liang, H.Y., et al. (2021) Associa-tion between Prior Calcium Channel Blocker Use and Mortality in Septic Patients: A Meta-Analysis of Cohort Studies. Frontiers in Pharmacology, 12, Article 628825. [Google Scholar] [CrossRef] [PubMed]
[30] Weinrauch, L.A., Liu, J., Claggett, B., et al. (2018) Calcium Chan-nel Blockade and Survival in Recipients of Successful Renal Transplant: An Analysis of the FAVORIT Trial Results. International Journal of Nephrology and Renovascular Disease, 11, 1-7. [Google Scholar] [CrossRef] 
[31] Obialo, C.I., Conner, A.C. and Lebon, L. (2000) Calcium Channel Blockers Do Not Prevent Catheter Associated Infections in Hemodialysis Patients. American Journal of Hypertension, 13, 123A. [Google Scholar] [CrossRef] 
[32] Alexiewicz, J.M., Smogorzewski, M., Klin, M., Akmal, M. and Massry, S.G. (1995) Effect of Treatment of Hemodialysis Patients with Nifedipine on Metabolism and Function of Polymorphonuclear Leukocytes. American Journal of Kidney Diseases, 25, 440-444. [Google Scholar] [CrossRef] 
[33] Obialo, C.I., Conner, A.C. and Lebon, L.F. (2002) Calcium Blocking Agents Do Not Ameliorate Hemodialysis Catheter Bacteremia. Dialysis & Transplantation, 31, 848-854.
[34] Nanni, G., Pannochia, N., Tacchino, R., Foco, M., Piccioni, E. and Castagneto, M. (2000) Increased In-cidence of Infection in Verapamil-Treated Kidney Transplant Recipients. Transplantation Proceedings, 32, 551-553. [Google Scholar] [CrossRef] 

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