Department of Physiological Sciences, Stellenbosch University, Private Bag X1, Matieland, Stellenbosch, 7600, South Africa.
Crit Care. 2017 Aug 3;21(1):202. doi: 10.1186/s13054-017-1775-1.
There is an ongoing debate regarding the efficacy of glycaemic control in critically ill patients. Here we briefly highlight the key function of elevated glucose in critically ill patients, namely, to enable elevation of aerobic glycolysis in rapidly dividing cells. In particular, aerobic glycolysis provides metabolic intermediates necessary for expansion of biomass in immune cells and promotion of tissue repair. Furthermore, we emphasise that insulin may inhibit autophagy, a cell survival process used in the bulk degradation of cellular debris and damaged organelles. These observations provide a rational basis for tolerating elevated glucose levels in certain critically ill patients.
关于危重患者血糖控制的疗效一直存在争议。在这里，我们简要地强调了升高的葡萄糖在危重患者中的关键作用，即能够使快速分裂细胞中的有氧糖酵解升高。具体而言，有氧糖酵解提供了免疫细胞中生物量扩张和组织修复所必需的代谢中间产物。此外，我们强调胰岛素可能会抑制自噬，这是一种用于细胞碎片和受损细胞器大量降解的细胞存活过程。这些观察结果为在某些危重患者中耐受升高的血糖水平提供了合理的依据。
