Leverve Xavier M
INSERM-E0221 Bioénergétique Fondamentale et Appliquée, Université J Fourier, Grenoble, France.
Crit Care. 2005;9(6):622-3. doi: 10.1186/cc3935. Epub 2005 Nov 25.
Lactate, indispensable substrate of mammalian intermediary metabolism, allows shuttling of carbons and reducing power between cells and organs at a high turnover rate. Lactate is, therefore, not deleterious, although an increase in its concentration is often a sensitive sign of alteration in energy homeostasis, a rise in it being frequently related to poor prognosis. Such an increase, however, actually signifies an attempt by the body to cope with a new energy status. Hyperlactatemia, therefore, most often represents an adaptive response to an acute energy disorder. Investigation of lactate metabolism at the bedside is limited to the determination of its concentration. Lactate metabolism and acid-base homeostasis are both closely linked to cellular energy metabolism, acidosis being potentially a cause or a consequence of cellular energy deficit.
乳酸是哺乳动物中间代谢不可或缺的底物，它能使碳和还原力以高周转率在细胞和器官之间穿梭。因此，乳酸并非有害物质，尽管其浓度升高往往是能量稳态改变的敏感迹象，且其升高常常与预后不良相关。然而，这种升高实际上表明身体试图应对新的能量状态。因此，高乳酸血症最常代表对急性能量紊乱的适应性反应。床边对乳酸代谢的研究仅限于测定其浓度。乳酸代谢和酸碱稳态均与细胞能量代谢密切相关，酸中毒可能是细胞能量缺乏的原因或结果。
