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中华重症医学电子杂志 ›› 2025, Vol. 11 ›› Issue (04) : 387 -396. doi: 10.3877/cma.j.issn.2096-1537.2025.04.009

综述

慢性危重症分解代谢与营养支持的研究进展
苏婉婷, 丁仁彧()   
  1. 110001 沈阳,中国医科大学附属第一医院重症医学科
  • 收稿日期:2025-03-24 出版日期:2025-11-28
  • 通信作者: 丁仁彧
  • 基金资助:
    国家自然科学基金项目(82172174); 辽宁省“兴辽英才计划”项目(XLYC2007001); 教育部“长江学者奖励计划”项目(TG2019081)

Catabolism and nutritional support in chronic critical illness

Wanting Su, Renyu Ding()   

  1. Department of Intensive Care Unit, the First Hospital of China Medical University, Shenyang 110001, China
  • Received:2025-03-24 Published:2025-11-28
  • Corresponding author: Renyu Ding
引用本文:

苏婉婷, 丁仁彧. 慢性危重症分解代谢与营养支持的研究进展[J/OL]. 中华重症医学电子杂志, 2025, 11(04): 387-396.

Wanting Su, Renyu Ding. Catabolism and nutritional support in chronic critical illness[J/OL]. Chinese Journal of Critical Care & Intensive Care Medicine(Electronic Edition), 2025, 11(04): 387-396.

随着重症医学诊疗技术的不断提升,危重症患者早期病死率大幅度降低,但部分存活患者仍存在持续性多器官功能障碍,需长期滞留于ICU,临床中将其定义为慢性危重症(CCI)。此类患者常伴有显著的分解代谢亢进,严重影响其预后和生存质量。本文系统综述CCI的定义、流行病学、分解代谢的发生机制,包括持续炎症反应、神经内分泌失调等对骨骼肌等组织代谢的影响。同时,梳理CCI患者分解代谢相关的生物标志物及营养支持的关键作用,涵盖肠内营养、膳食或营养添加及合成代谢药物等的应用效果和适宜策略。通过对现有研究的总结,旨在为临床中更有效地实施针对CCI分解代谢的营养支持治疗提供参考,以改善患者结局,推动CCI相关研究的进一步发展。

With the continuous advancement of critical care medicine, early mortality among critically ill patients has significantly declined. However, a subset of survivors continue to experience persistent multi-organ dysfunction, requiring prolonged stays in the intensive care unit (ICU). These patients are clinically defined as having chronic critical illness (CCI). Notably, CCI is characterized by marked hypercatabolism, which severely impacts prognosis and quality of life. This article systematically reviews the definition, epidemiology, and pathophysiological mechanisms of hypercatabolism in CCI, including the roles of sustained inflammatory responses, neuroendocrine dysregulation, and their effects on tissue metabolism—particularly skeletal muscle catabolism. Furthermore, we summarize biomarkers associated with hypercatabolism in CCI patients and evaluate the critical role of nutritional support strategies, such as enteral nutrition, nutritional adjuvants, and anabolic agents, in mitigating metabolic dysregulation. By synthesizing current evidence, this review aims to provide reference for optimizing nutrition-focused interventions in CCI patients, ultimately improving clinical outcomes and guiding future research directions in this evolving field.

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[14] 潘赛波, 韩佳, 吴明, 于振涛. 食管癌患者围手术期肠内营养置管及通路管理专家共识[J/OL]. 中华胸部外科电子杂志, 2026, 13(01): 1-13.
[15] 李平, 梁伟芬, 张艺军, 肖桂珍, 郑林鑫, 李好华. 营养支持在老年晚期肺癌患者呼吸康复治疗中的作用[J/OL]. 中华老年病研究电子杂志, 2023, 10(01): 20-25.
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