创伤和脓毒症中脂肪细胞脂解的肾上腺素能控制
Adrenergic control of adipocyte lipolysis in trauma and sepsis.
作者信息
Forse R A, Leibel R, Askanazi J, Hirsch J, Kinney J M
机构信息
Department of Surgery, College of Physicians and Surgeons of Columbia University, New York, New York.
出版信息
Ann Surg. 1987 Dec;206(6):744-51. doi: 10.1097/00000658-198712000-00010.
Adipocyte lipolysis and its adrenergic control were studied in vitro from normal patients and those with trauma and sepsis. The adrenergic receptors were studied in terms of their responsiveness, a measure of the postreceptor mechanism, and their sensitivity, a measure of the receptor number or affinity. With early trauma, beta-adrenergic responsiveness and receptor number were significantly decreased. This is desensitization of the beta-receptors with down regulation and indicates increased in vivo lipolysis in early injury. After 4 days these changes had returned to normal. Early sepsis resulted in a significant increase in beta- and alpha-receptor responsiveness with beta-upregulation. This indicated hypersensitivity of the adipocyte adrenergic receptors and suggests the presence of an in vivo block of the adrenergic receptors in early sepsis. This would decrease adipocyte lipolysis. After 4 days there was a decrease in beta-receptor responsiveness in the patients with sepsis, indicating that the adrenergic receptor block was no longer present and adipocyte adrenergic stimulated lipolysis was increased.
在体外研究了正常患者以及创伤和脓毒症患者的脂肪细胞脂解作用及其肾上腺素能调控。从受体后机制的衡量指标反应性以及受体数量或亲和力的衡量指标敏感性方面研究了肾上腺素能受体。早期创伤时，β肾上腺素能反应性和受体数量显著降低。这是β受体下调脱敏，表明早期损伤时体内脂解增加。4天后这些变化恢复正常。早期脓毒症导致β和α受体反应性显著增加以及β上调。这表明脂肪细胞肾上腺素能受体超敏，并提示早期脓毒症时存在肾上腺素能受体的体内阻断。这会减少脂肪细胞脂解。4天后，脓毒症患者的β受体反应性降低，表明肾上腺素能受体阻断不再存在，脂肪细胞肾上腺素能刺激的脂解增加。
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