Cerra F B, Siegel J H, Border J R, Peters D M, McMenamy R R
J Trauma. 1979 Aug;19(8):621-9. doi: 10.1097/00005373-197908000-00010.
Simultaneous longitudinal hormonometabolic-physiologic (cardiopulmonary) profiles were measured in 14 nonseptic trauma/general surgery (T/GS) patients and in ten patients with Gram-negative abdominal surgical sepsis. The physiologic state classification system was used as the frame of reference. There were no response differences between the T and GS groups: they had A State responses. The sepsis (S) patients initially had exaggerated A State responses with significant changes in glucose, fat, amino acid, and glucagon plasma levels relative to T/GS. The S patients who survived (four) demonstrated profiles as in T/GS. The S patients who expired (six) progressively evolved an unbalanced, hyperdynamic B State response with progressive elevations of glucose, lactate, aromatic and branched-chain amino acids and glucagon, and low ketone bodies. There is definite correlation over time between metabolic and physiologic responses; the physiologic responses reflect the metabolic responses; the metabolic responses are consistent with a peripheral energy-fuel deficit.
对14例非脓毒症创伤/普通外科（T/GS）患者和10例革兰阴性菌腹部手术脓毒症患者同时进行了纵向激素代谢-生理（心肺）指标测定。以生理状态分类系统作为参照标准。T组和GS组之间没有反应差异：两组均表现为A状态反应。脓毒症（S）患者最初表现为A状态反应过度，相对于T/GS组，其血糖、脂肪、氨基酸和胰高血糖素血浆水平有显著变化。存活的S组患者（4例）表现与T/GS组相同。死亡的S组患者（6例）逐渐演变为失衡的高动力B状态反应，血糖、乳酸、芳香族和支链氨基酸以及胰高血糖素水平逐渐升高，酮体水平降低。代谢反应和生理反应随时间存在明确的相关性；生理反应反映代谢反应；代谢反应与外周能量燃料缺乏一致。
