Anabolic hormones in critically ill patients.
Anabolic hormones in critically ill patients.
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DOI：
10.1097/00075197-199903000-00014
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发表时间：
1999-03-01
影响因子：
3.1
通讯作者：
Ferrando, A A
中科院分区：
文献类型：
--
作者：
Ferrando, A A
危重疾病和严重损伤会引起许多神经内分泌变化，这些变化最初会提高生存率。然而，对于骨骼肌来说，激素环境以加速分解代谢为主。普遍存在的高皮质醇血症因合成代谢激素的抵抗或合成代谢激素的产生减少或两者兼而有之而加剧。由此导致的去脂体重损失会损害患者处理急性并发症的能力，并损害康复的努力。由于这些原因，人们的努力集中在恢复合成代谢的影响上。最近的研究继续表明，通过激素管理可以改善肌肉分解代谢。新兴技术和保守的给药方案有望发展恢复合成代谢影响的临床能力，同时最大限度地减少不良副作用。
Critical illness and severe injury induce a number of neuroendocrine changes that initially enhance survival. However, for skeletal muscle, the hormonal environment is such that accelerated catabolism predominates. The prevailing hypercortisolemia is exacerbated by a resistance to or decreased production of anabolic hormones, or both. The resulting loss of lean body mass compromises the patient's ability to handle acute complications and impairs efforts towards rehabilitation. For these reasons, efforts have been focused upon the restoration of the anabolic influence. Recent studies continue to demonstrate that the amelioration of muscle catabolism is possible with hormonal management. Emerging technologies and conservative administration regimens hold promise for the development of the clinical ability to restore anabolic influence, while minimizing undesirable side effects.