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中华临床医师杂志(电子版) ›› 2023, Vol. 17 ›› Issue (06) : 749 -753. doi: 10.3877/cma.j.issn.1674-0785.2023.06.021

综述

脓毒症中高密度脂蛋白、载脂蛋白A-I和血清淀粉样蛋白A的作用研究进展
谭睿, 王晶, 於江泉(), 郑瑞强   
  1. 116044 大连,大连医科大学
    225000 扬州,江苏省苏北人民医院重症医学科
  • 收稿日期:2022-04-27 出版日期:2023-06-15
  • 通信作者: 於江泉
  • 基金资助:
    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)

Progress in understanding of role of high density lipoprotein, apolipoprotein A-I, and serum amyloid A in sepsis

Rui Tan, Jing Wang, Jiangquan Yu(), Ruiqiang Zheng   

  1. Inner Mongolia Medical University, Hohhot 010110, China
    Intensive Care Unit, Northern Jiangsu People's Hospital, Yangzhou 225001, China
  • Received:2022-04-27 Published:2023-06-15
  • Corresponding author: Jiangquan Yu
引用本文:

谭睿, 王晶, 於江泉, 郑瑞强. 脓毒症中高密度脂蛋白、载脂蛋白A-I和血清淀粉样蛋白A的作用研究进展[J]. 中华临床医师杂志(电子版), 2023, 17(06): 749-753.

Rui Tan, Jing Wang, Jiangquan Yu, Ruiqiang Zheng. Progress in understanding of role of high density lipoprotein, apolipoprotein A-I, and serum amyloid A in sepsis[J]. Chinese Journal of Clinicians(Electronic Edition), 2023, 17(06): 749-753.

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。

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.

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