摘要
高密度脂蛋白（HDL）在脓毒症期间可通过载脂蛋白A-I（ApoA-I）结合和移动革兰氏阴性菌的内毒素和革兰氏阳性菌的脂磷壁酸。脓毒症时，血清淀粉样蛋白A（SAA）的表达显著增加，HDL中的ApoA-I被SAA替代，使血浆HDL水平显著降低，是脓毒症的独立危险因素。HDL在脓毒症期间出现功能失调，SAA在HDL结构及功能的变化中的具体作用机制尚未明确，本文就脓毒症期间HDL、ApoA-I和SAA的变化趋势，相互之间的作用，以及各指标在临床中的应用作一综述，为脓毒症中脂蛋白及相关载脂蛋白的进一步研究提供理论基础。
Abstract
High-density lipoprotein (HDL) can bind and neutralize the endotoxin of Gram-negative bacteria and lipoteichoic acid of Gram-positive bacteria through apolipoprotein A-I (ApoA-I) during sepsis. The expression of serum amyloid A (SAA) is significantly increased in sepsis, and ApoA-I in HDL is replaced by SAA, resulting in a significant reduction in plasma HDL levels, an independent risk factor for sepsis. HDL has dysfunction during sepsis, and the exact mechanism of SAA in altering HDL structure and function is not clear. This paper reviews the change trend of HDL, ApoA-I, and SAA during sepsis, the interaction between them, and the clinical application of various indexes, to provide a theoretical basis for the further study of lipoproteins and related apolipoproteins in sepsis.
基金项目
江苏省青年医学人才项目(QNRC2016318)
江苏省六个一拔尖人才项目(LGY2019036)
扬州市社会发展计划-面上项目(YZ2018075)
扬州市重点医学人才项目(ZDRC2018045)
万方数据