Odeh M
Department of Internal Medicine B, Bnai Zion Medical Center, Haifa, Israel.
Int J Cardiol. 1993 Dec 31;42(3):231-8. doi: 10.1016/0167-5273(93)90053-j.
Most patient with sepsis and septic shock develop significant derangements of myocardial function. The presence of a circulating myocardial depressant substance (MDS) has been suggested to be the major cause of myocardial depression in sepsis and septic shock. MDS is still not fully characterized by chemical means, and there is no consensus regarding its identity. Nevertheless, high levels of MDS activity can be found in sera from patients with sepsis and septic shock. Furthermore, MDS has been shown to have a number of specific characteristics. These characteristics have also been described with tumor necrosis factor-alpha (TNF), a cytokine that is well recognized to be a primary mediator in the pathogenesis of infection, tissue injury, inflammation and shock. In this review it is suggested that TNF is an MDS, and that the cardiovascular injury and myocardial depression during sepsis and septic shock involve a final common pathway, where TNF may have an important role in this common pathway.
大多数脓毒症和脓毒性休克患者会出现明显的心肌功能紊乱。循环中的心肌抑制物质（MDS）被认为是脓毒症和脓毒性休克中心肌抑制的主要原因。MDS仍未通过化学方法完全表征，并且关于其身份也没有达成共识。然而，在脓毒症和脓毒性休克患者的血清中可以发现高水平的MDS活性。此外，MDS已被证明具有许多特定特征。肿瘤坏死因子-α（TNF）也具有这些特征，TNF是一种细胞因子，在感染、组织损伤、炎症和休克的发病机制中被公认为主要介质。在这篇综述中，有人提出TNF是一种MDS，并且脓毒症和脓毒性休克期间的心血管损伤和心肌抑制涉及一条最终的共同途径，其中TNF可能在这条共同途径中起重要作用。
