Lefevre G, Dhainaut J F, Tallet F, Huyghebaert M F, Yonger J, Monsallier J F, Raichvarg D
Laboratoire de Biochimie A, Hopital Cochin, Paris, France.
Ann Clin Biochem. 1988 Sep;25 ( Pt 5):546-51. doi: 10.1177/000456328802500512.
Coronary haemodynamics and myocardial metabolism of nonesterified fatty acids (NEFA) and lactate were studied in 11 patients with severe sepsis, and compared to 10 control subjects. Coronary sinus blood flow was evaluated by thermodilution. Arterial and coronary sinus blood samples were collected for the measurement of lactate and total and individual NEFA concentrations both in septic and control patients. There was an increase in lactate and total NEFA arterial concentrations with a marked increase in palmitic and linolenic acids. The uptake of the main NEFA (C14:0 to C18:2) was significantly decreased. In the control group, individual NEFA uptake was proportional to their arterial concentrations. This relationship was not observed in patients with sepsis: there was no preferential extraction of any particular NEFA. Furthermore, in patients with sepsis, myocardial oxygen consumption did not correlate with NEFA, but only with lactate uptake. Alterations in NEFA uptake were found to be constant during severe sepsis and are consistent with major disturbances in myocardial metabolism.
对11例严重脓毒症患者的冠状动脉血流动力学以及非酯化脂肪酸（NEFA）和乳酸的心肌代谢进行了研究，并与10名对照受试者进行了比较。通过热稀释法评估冠状窦血流量。采集脓毒症患者和对照患者的动脉血和冠状窦血样本，以测量乳酸以及总NEFA和单个NEFA的浓度。乳酸和总NEFA的动脉浓度升高，棕榈酸和亚麻酸显著增加。主要NEFA（C14:0至C18:2）的摄取显著降低。在对照组中，单个NEFA的摄取与其动脉浓度成正比。脓毒症患者未观察到这种关系：没有对任何特定NEFA的优先提取。此外，在脓毒症患者中，心肌耗氧量与NEFA无关，仅与乳酸摄取有关。发现严重脓毒症期间NEFA摄取的改变是持续的，并且与心肌代谢的主要紊乱一致。
