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Optimizing cerebral glucose in severe traumatic brain injury: still some way to go.优化重度创伤性脑损伤患者的脑葡萄糖代谢：仍有很长的路要走。
Crit Care. 2009;13(2):131. doi: 10.1186/cc7753. Epub 2009 Apr 6.
2
Impact of tight glycemic control on cerebral glucose metabolism after severe brain injury: a microdialysis study.严格血糖控制对重度脑损伤后脑葡萄糖代谢的影响：一项微透析研究。
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Glucose control in acute brain injury: does it matter?急性脑损伤中的血糖控制：有关系吗？
Curr Opin Crit Care. 2016 Apr;22(2):120-7. doi: 10.1097/MCC.0000000000000292.
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Tight glycemic control increases metabolic distress in traumatic brain injury: a randomized controlled within-subjects trial.严格的血糖控制会增加创伤性脑损伤的代谢紊乱：一项随机对照的within-subjects 试验。
Crit Care Med. 2012 Jun;40(6):1923-9. doi: 10.1097/CCM.0b013e31824e0fcc.
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Brain metabolism is significantly impaired at blood glucose below 6 mM and brain glucose below 1 mM in patients with severe traumatic brain injury.在严重创伤性脑损伤患者中，当血糖低于 6mM 和脑葡萄糖低于 1mM 时，大脑代谢会显著受损。
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Relationship between systemic glucose and cerebral glucose is preserved in patients with severe traumatic brain injury, but glucose delivery to the brain may become limited when oxidative metabolism is impaired: implications for glycemic control.严重创伤性脑损伤患者的全身葡萄糖与脑葡萄糖之间存在关系，但当氧化代谢受损时，向大脑输送葡萄糖可能会受到限制：这对血糖控制有影响。
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本文引用的文献

1
Differential influence of arterial blood glucose on cerebral metabolism following severe traumatic brain injury.严重创伤性脑损伤后动脉血糖对脑代谢的影响差异。
Crit Care. 2009;13(1):R13. doi: 10.1186/cc7711. Epub 2009 Feb 6.
2
Early derangements in oxygen and glucose metabolism following head injury: the ischemic penumbra and pathophysiological heterogeneity.头部损伤后早期的氧和葡萄糖代谢紊乱：缺血半暗带与病理生理异质性
Neurocrit Care. 2008;9(3):319-25. doi: 10.1007/s12028-008-9119-2.
3
Hyperglycemia and cerebral glucose in aneurysmal subarachnoid hemorrhage.动脉瘤性蛛网膜下腔出血中的高血糖与脑葡萄糖
Intensive Care Med. 2008 Jul;34(7):1200-7. doi: 10.1007/s00134-008-1044-5. Epub 2008 Mar 5.
4
The management of plasma glucose in acute cerebral ischaemia and traumatic brain injury: more research needed.急性脑缺血和创伤性脑损伤中血糖的管理：仍需更多研究。
Intensive Care Med. 2008 Jul;34(7):1169-72. doi: 10.1007/s00134-008-1045-4. Epub 2008 Mar 5.
5
Glucose and the ischaemic brain: too much of a good thing?葡萄糖与缺血性脑：有益之物是否过量？
Lancet Neurol. 2007 May;6(5):380-1. doi: 10.1016/S1474-4422(07)70086-8.
6
Intensive insulin therapy reduces microdialysis glucose values without altering glucose utilization or improving the lactate/pyruvate ratio after traumatic brain injury.强化胰岛素治疗可降低创伤性脑损伤后的微透析葡萄糖值，但不改变葡萄糖利用率或改善乳酸/丙酮酸比值。
Crit Care Med. 2006 Mar;34(3):850-6. doi: 10.1097/01.CCM.0000201875.12245.6F.
7
Vasoconstrictive neurovascular coupling during focal ischemic depolarizations.局灶性缺血性去极化期间的血管收缩性神经血管耦合
J Cereb Blood Flow Metab. 2006 Aug;26(8):1018-30. doi: 10.1038/sj.jcbfm.9600252. Epub 2005 Dec 7.
8
Insulin therapy protects the central and peripheral nervous system of intensive care patients.胰岛素治疗可保护重症监护患者的中枢和周围神经系统。
Neurology. 2005 Apr 26;64(8):1348-53. doi: 10.1212/01.WNL.0000158442.08857.FC.
9
Hyperglycemia and brain tissue pH after traumatic brain injury.
Neurosurgery. 2004 Oct;55(4):877-81; discussion 882. doi: 10.1227/01.neu.0000137658.14906.e4.
10
Persistently low extracellular glucose correlates with poor outcome 6 months after human traumatic brain injury despite a lack of increased lactate: a microdialysis study.尽管乳酸水平未升高，但人类创伤性脑损伤6个月后，细胞外葡萄糖持续偏低与不良预后相关：一项微透析研究。
J Cereb Blood Flow Metab. 2003 Jul;23(7):865-77. doi: 10.1097/01.WCB.0000076701.45782.EF.

优化重度创伤性脑损伤患者的脑葡萄糖代谢：仍有很长的路要走。

Optimizing cerebral glucose in severe traumatic brain injury: still some way to go.

作者信息

Zahed Cameron, Gupta Arun K

机构信息

Addenbrooke's Hospital, Cambridge University Hospitals NHS Foundation Trust, Hills Road, Cambridge CB2 2QQ, UK.

出版信息

Crit Care. 2009;13(2):131. doi: 10.1186/cc7753. Epub 2009 Apr 6.

DOI:10.1186/cc7753
PMID:19435477
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC2689477/
Abstract

This commentary considers some of the factors that affect cerebral glucose metabolism in patients with traumatic brain injury. A study recently reported in Critical Care suggested a blood glucose range that may optimize cerebral glucose utilization; the findings of this study are evaluated and discussed. Some of the mechanisms of cerebral glucose control are explored, including the impact of intensive insulin therapy on cerebral metabolism.

摘要

本评论探讨了影响创伤性脑损伤患者脑葡萄糖代谢的一些因素。《重症监护》杂志最近报道的一项研究提出了一个可能使脑葡萄糖利用最优化的血糖范围；对该研究的结果进行了评估和讨论。探讨了脑葡萄糖控制的一些机制，包括强化胰岛素治疗对脑代谢的影响。