余祺 万勇 左友波 文笛

    [摘要]严重感染、创伤、大手术和麻醉后，患者往往会产生一系列的异常代谢，包括高代谢、高分解和营养物、激素异常代谢，这些变化进一步扰乱内稳态，影响细胞能量代谢和功能，成为围术期导致心肌损伤的重要原因。近年来，研究发现代谢改变与围术期心肌损伤(PMI)密切相关。本文将从围术期代谢改变及其对 PMI 的影响、改善围术期代谢变化的措施等方面进行综述，以期为 PMI 的深入研究和早期预防提供临床参考。

    [关键词]围术期心肌损伤;代谢;胰岛素抵抗;药物;术前口服碳水化合物

    [中图分类号] R619; R542.2? [文献标识码] A? [文章编号]2095-0616(2021)23-0057-04

    Advances in study on the effect of metabolic alterations on perioperative myocardial injury

    YU? Qi? WAN? Yong? ZUO? Youbo? WEN? Di

    Department of Anesthesiology， Affiliated Hospital of North Sichuan Medical College， Sichuan， Nanchong 637000，China

    [Abstract] Patients undergoing severe infection， trauma， major surgery and anesthesia often develop a series of abnormal metabolism， including hypermetabolism， high decomposition and abnormal metabolism of nutrients and hormones. These alterations further disturb homeostasis and affect cellular energy metabolism and function， which become important cause of perioperative myocardial injury (PMI). In recent years， studies have found that metabolic alterations are closely associated to PMI. This paper reviews the perioperative metabolic alterations and their effects on PMI ......