Souba W W
Division of Surgical Oncology, Massachusetts General Hospital, Boston.
Curr Probl Surg. 1994 Jul;31(7):577-643. doi: 10.1016/0011-3840(94)90047-7.
During the last two decades, major advances in technology and in our fundamental understanding of the biologic aspects of sepsis and cancer cachexia have dramatically affected the therapeutic strategies available to the surgeon to care for critically ill patients. It is clear, however, that cytokines affect whole body nutrition and metabolism and are responsible for many of the clinically observed nutritional effects of injury, infection, and cancer, including fever, hypermetabolism, anorexia, protein catabolism, cachexia, and altered fat, glucose, and trace mineral metabolism. These metabolic and nutritional effects of cytokines are influenced by the nutritional status of the host, which is generally altered during the course of the critical illness. In the future, the use of specialized diets and the use of selective cytokine blockade are likely to be important components of the overall care of the catabolic patient.
在过去二十年中，技术的重大进步以及我们对脓毒症和癌症恶病质生物学方面的基本认识，极大地影响了外科医生治疗重症患者时可采用的治疗策略。然而，很明显，细胞因子会影响全身营养和代谢，并且是损伤、感染和癌症许多临床观察到的营养效应的原因，包括发热、高代谢、厌食、蛋白质分解代谢、恶病质以及脂肪、葡萄糖和微量矿物质代谢改变。细胞因子的这些代谢和营养效应受宿主营养状况的影响，而宿主营养状况在危重病过程中通常会发生改变。未来，使用特殊饮食和选择性细胞因子阻断可能会成为分解代谢患者整体护理的重要组成部分。
