维生素C：脓毒症期间一种必需的“应激激素”。
Vitamin C: an essential "stress hormone" during sepsis.
作者信息
Marik Paul E
机构信息
Division of Pulmonary and Critical Care Medicine, Eastern Virginia Medical School, Norfolk, VA, USA.
出版信息
J Thorac Dis. 2020 Feb;12(Suppl 1):S84-S88. doi: 10.21037/jtd.2019.12.64.
Abstract
The stress response is a preserved evolutionary response that functions to enhance the survival of the species. In mammals, the stress response is characterized by activation of the HPA axis and sympathoadrenal system (SAS) as well as the increased synthesis and secretion of vitamin C. Cortisol, catecholamines, and vitamin C act synergistically to increase hemodynamic reserve, maintain immune function and protect the host against excessive oxidant injury. Humans (and anthropoid apes) have lost the ability to synthesize vitamin C and therefore have an impaired stress response. The inability to produce vitamin C has serious implications in septic humans. Treatment with vitamin C appears to restore the stress response and improve the survival of stressed humans.
摘要
应激反应是一种保留下来的进化反应，其作用是提高物种的生存能力。在哺乳动物中，应激反应的特征是下丘脑-垂体-肾上腺（HPA）轴和交感-肾上腺系统（SAS）的激活以及维生素C合成和分泌的增加。皮质醇、儿茶酚胺和维生素C协同作用，以增加血流动力学储备、维持免疫功能并保护宿主免受过度的氧化损伤。人类（以及类人猿）已经失去了合成维生素C的能力，因此应激反应受损。无法产生维生素C对感染性休克患者有严重影响。用维生素C治疗似乎可以恢复应激反应并提高应激状态下人类的生存率。
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