Approach to elucidate the pathogenesis of multiple organ disfunction syndrome in critically ill patients

鉴于多器官功能障碍综合征（MODS）的发病机制与终末期糖尿病（DM）相似，本文结合近年来DM的研究进展，对MODS的发病机制进行了探讨。在MODS死亡的患者中，我们在肾脏和肝脏中均发现了胰岛素原阳性细胞。这些细胞在共聚焦研究中也呈TNF-α阳性。提示高糖可诱导骨髓中胰岛素原阳性细胞向内脏器官浸润，释放TNF-α，导致MODS的发生。

On the aspect that the pathogenesis of multiple organ dysfunction syndromes (MODS) is resembles to that of end-stage diabetes mellitus (DM) patients, we investigated the mechanism of MODS by referring the results of recent advance of DM research. In patients who died by MODS, we found the proinsulin positive cells in both kidney and liver. These cells were also TNF-alpha positive in confocal study. These results suggest that the high glucose induces proinsulin positive cells in bone marrow, and those cells invade to visceral organs, release a TNF-alpha, and resulted in MODS.