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高中心静脉血氧饱和度与脓毒性休克中线粒体功能障碍相关:一项前瞻性观察研究。

High central venous oxygen saturation is associated with mitochondrial dysfunction in septic shock: A prospective observational study.

机构信息

Department of Emergency Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

Cardiac Electrophysiology Research and Training Center, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.

出版信息

J Cell Mol Med. 2020 Jun;24(11):6485-6494. doi: 10.1111/jcmm.15299. Epub 2020 Apr 30.

DOI:10.1111/jcmm.15299
PMID:32352229
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7294163/
Abstract

To test the hypothesis that an impaired mitochondrial function is associated with altered central venous oxygen saturation (ScvO ), venous-to-arterial carbon dioxide tension difference (delta PCO ) or serum lactate in sepsis patients. This prospective cohort study was conducted in a single tertiary emergency department between April 2017 and March 2019. Patients with suspected sepsis were included in the study. Serum lactate was obtained in sepsis, ScvO and delta PCO were evaluated in septic shock patients. Mitochondrial function was determined from the peripheral blood mononuclear cells. Forty-six patients with suspected sepsis were included. Of these, twenty patients were septic shock. Mitochondrial oxidative stress levels were increased in the high ScvO group (ScvO  > 80%, n = 6), compared with the normal (70%-80%, n = 9) and low ScvO (<70%, n = 5) groups. A strong linear relationship was observed between the mitochondrial oxidative stress and ScvO (r = .75; P = .01). However, mitochondrial respiration was increased in the low ScvO group. In addition, mitochondrial complex II protein levels were significantly decreased in the high ScvO group (P < .05). Additionally, there was no correlation between serum lactate, delta PCO , and mitochondria oxidative stress or mitochondria function. ScvO can be potentially useful for developing new therapeutics to reduce mitochondrial dysfunction in septic shock patient.

摘要

为了验证假设,即线粒体功能受损与脓毒症患者中心静脉血氧饱和度(ScvO )、静脉-动脉二氧化碳分压差(delta PCO )或血清乳酸改变有关。本前瞻性队列研究于 2017 年 4 月至 2019 年 3 月在一家三级急诊部进行。研究纳入疑似脓毒症患者。在脓毒症中获得血清乳酸,在感染性休克患者中评估 ScvO 和 delta PCO 。从外周血单核细胞中确定线粒体功能。共纳入 46 例疑似脓毒症患者,其中 20 例为感染性休克。与正常(70%-80%,n=9)和低 ScvO (<70%,n=5)组相比,高 ScvO 组(ScvO >80%,n=6)的线粒体氧化应激水平升高。线粒体氧化应激与 ScvO 之间存在很强的线性关系(r=.75;P=.01)。然而,低 ScvO 组的线粒体呼吸增加。此外,高 ScvO 组的线粒体复合物 II 蛋白水平显著降低(P <.05)。此外,血清乳酸、delta PCO 与线粒体氧化应激或线粒体功能之间无相关性。ScvO 可能有助于开发新的治疗方法,以减少感染性休克患者的线粒体功能障碍。

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