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首页> 外文期刊>Frontiers in neuroendocrinology >Dynamic neuroendocrine responses to critical illness.
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Dynamic neuroendocrine responses to critical illness.

机译：对严重疾病的动态神经内分泌反应。

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摘要

Prolonged critical illness has high morbidity and mortality. The acute neuroendocrine response to critical illness involves an activated anterior pituitary function. In prolonged critical illness, however, a reduced pulsatile secretion of anterior pituitary hormones and the so-called 'wasting syndrome' occur. The impaired pulsatile secretion of growth hormone (GH), thyrotropin and gonadotropin can be re-amplified by relevant combinations of releasing factors, which also substantially increase circulating levels of insulin-like growth factor (IGF)-I, GH-dependent IGF-binding proteins, thyroxine, tri-iodothyronine, and testosterone. Anabolism is clearly re-initiated when GH secretagogues, thyrotropin-releasing and gonadotropin-releasing hormones are co-administered but the effect on survival remains unknown. A lethal outcome of critical illness is predicted by a high serum concentration of IGF-binding protein 1, pointing to impaired insulin effect rather than pituitary function, and survival was recently shown to be dramatically improved by strict normalization of glycemia with exogenous insulin. The recent progress in the knowledge of the neuroendocrine response to critical illness and its interrelation with peripheral hormonal and metabolic alterations during stress allows for potential new therapeutic perspectives to safely reverse the wasting syndrome and improve survival. These novel insights will be reviewed herein.
机译：长期危重疾病的发病率和死亡率很高。对重症的急性神经内分泌反应涉及激活的垂体前叶功能。然而，在长期危重疾病中，垂体前叶激素的搏动分泌减少，发生所谓的“消瘦综合症”。生长激素（GH），促甲状腺激素和促性腺激素的搏动分泌受损可以通过释放因子的相关组合重新放大，这也大大增加了胰岛素样生长因子（IGF）-I，GH依赖的IGF结合的循环水平蛋白质，甲状腺素，三碘甲状腺素和睾丸激素。当GH促分泌素，促甲状腺激素释放激素和促性腺激素释放激素合用时，显然可以重新开始合成代谢，但对存活的影响尚不清楚。血清IGF结合蛋白1的高浓度预示着重大疾病的致命后果，这表明胰岛素作用受损而不是垂体功能受损，近来，通过严格控制外源性胰岛素血糖正常化，显着提高了生存率。对危重病的神经内分泌反应及其与应激过程中周围激素和代谢变化之间相互关系的认识方面的最新进展，为潜在的新治疗观点提供了可能，以安全地逆转消瘦综合征并提高生存率。这些新颖的见解将在这里进行回顾。

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