线粒体一氧化氮合酶在败血症休克性心功能抑制中的作用研究

发布时间：2018-06-03 11:38

本文选题：败血症休克 + 脂多搪　；参考：《浙江大学》2006年硕士论文

【摘要】：近几十年来,随着医学的发展,诊疗手段得到明显的改进和发展,但是败血症休克仍保持着较高的发病率和死亡率。目前败血症发病率正以每年9%的速度递增,至今发病率已达每10万人患者约为50-95例。败血症病人占入院病人的2%,其中9%的败血症病人会发展为重度败血症,重度败血症病人中3%会最终发展为败血症休克,而这部分病人的花费占了所有重症监护费用的10%。败血症休克具有特征性的血流动力学变化,在早期呈高动力期变化,此时心输出量、组织灌流量以及氧气的运输均增加;在晚期则表现为低动力期变化,此时心输出量、组织灌流量以及氧气的运输降低,最终引起全身持续性的低血压状态。这个变化就是败血症休克向不可逆性的和死亡发展的主要原因和标志。在败血症休克过程中,机体释放大量体液因子,如白细胞介素、肿瘤坏死因子等,这些活性因子均能诱导一氧化氮(nitric oxide,NO)的过量生成,而过量生成的NO被认为是引起败血症休克全身持续性低血压状态的重要原因。体内一氧化氮主要是由一氧化氮合酶(nitric oxide synthase,NOS)催化L-精氨酸生成的。现已公认的NOS主要有三种:诱导型NOS(inducible NOS,iNOS或NOS2)、内皮型NOS(endothelial NOS,eNOS或NOS3)和神经型NOB(neuronal NOS,nNOS或NOS1)。其中eNOS与nNOS合称为固定表达型NOS(constitutive NOS,eNOS)。1997年,由Ghafourifar和Richter发现在线粒体上存在一种有别于以上三种的NOS,称之为线粒体NOS(mitochondrial NOS,mtNOS)。我们认为,mtNOS作为细胞内一种新型NOB,有必要阐
[Abstract]:In recent decades, with the development of medicine, the methods of diagnosis and treatment have been obviously improved and developed, but septic shock still maintains a high incidence and mortality. At present, the incidence of septicemia is increasing at the rate of 9% per year, and the incidence has reached about 50-95 cases per 100000 population. Septicemia accounts for 2% of the hospitalized patients, of which 9% develop severe septicemia, 3% of severe septicemia eventually develop septic shock, and the cost of these patients accounts for 10% of all intensive care costs. Septic shock had characteristic hemodynamic changes, which showed a high dynamic phase at the early stage, in which cardiac output, tissue perfusion flow and oxygen transport were increased, but in the late stage, the cardiac output was changed in the low dynamic phase, and the cardiac output was increased in the late stage. Tissue perfusion and oxygen transport decrease, leading to persistent hypotension throughout the body. This change is the main cause and sign of the progression of septic shock to irreversibility and death. During septic shock, the body releases a large number of humoral factors, such as interleukin, tumor necrosis factor, etc. These active factors can induce the excessive production of nitric oxide (no). Excessive no production is considered to be an important cause of persistent hypotension in septic shock. The production of L-arginine is mainly catalyzed by nitric oxide synthase, nitric oxide synthase (nitrous oxide synthase) and nitric oxide synthase (NOS). There are three recognized NOS types: inducible NOS(inducible NOSnNOS or NOS2N, endothelial NOS(endothelial NOSnNOS or NOS3) and neuronal NOB(neuronal NOSnNOS or NOS1. In 1997, it was found by Ghafourifar and Richter that there was a kind of NOSs in mitochondria which were different from the above three species, called mitochondrial NOS(mitochondrial mtNOSs. We think that as a new type of NOB in cells, it is necessary to expound mtNOS.
【学位授予单位】：浙江大学
【学位级别】：硕士
【学位授予年份】：2006
【分类号】：R363

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