zdorПроблемы здоровья и экологииHealth and Ecology Issues2220-09672708-6011Gomel State Medical University10.51523/2708-6011.2024-21-3-01zdor-2634Research ArticleОБЗОРЫ И ЛЕКЦИИREVIEWS AND LECTURESОсобенности липидного метаболизма при синдроме полиорганной недостаточности: причины и следствия возникших изменений обменаFeatures of lipid metabolism in multiple organ dysfunction syndrome: causes and consequences of the resulting metabolic changeshttps://orcid.org/0000-0001-8836-8990ОсипенкоА. Н.OsipenkoA. N.

Осипенко Александр Николаевич, старший преподаватель кафедры естествознания,

Могилев

Alexander N. Osipenko, Senior Lecturer, Department of Natural Sciences,

Mogilev

alosipenko@yandex.ruhttps://orcid.org/0000-0003-1659-5902ТочилоС. А.TachylaS. A.

Точило Сергей Анатольевич, к.м.н., доцент, врач анестезиолог-реаниматолог отделения анестезиологии и реанимации;

заведующий филиалом кафедр анестезиологии и реаниматологии с курсом ФПК и ПК и госпитальной хирургии с курсом ФПК и ПК

Могилев

Siarhei A. Tachyla, Candidate of Medical Sciences, Associate Professor, Anesthesiologist-Reanimatologist at the Department of Anesthesiology and Intensive Care;

Head of the branch of Departments of Anesthesiology and Intensive Care with the course of Advanced Training and Retraining and the Department of Hospital Surgery with the course of Advanced Training and Retraining,

Vitebsk

tsa80@inbox.ruhttps://orcid.org/0000-0001-5092-8315МарочковА. В.MarochkovA. V.

Марочков Алексей Викторович, д.м.н., профессор, врач анестезиолог-реаниматолог отделения анестезиологии и реанимации;

профессор филиала кафедр анестезиологии и реаниматологии с курсом ФПК и ПК и госпитальной хирургиис курсом ФПК и ПК,

Могилев

Alexey V. Marochkov, Doctor of Medical Sciences, Professor, Anesthesiologist-Reanimatologist at the Department ofAnesthesiology and Intensive Care;

Professor of the branch of Departments of Anesthesiology and Intensive Care with the course of Advanced Trainingand Retraining and the Department of Hospital Surgery with the course of Advanced Training and Retraining,

Vitebsk

marochkov@mail.ruМогилевский государственный университет имени А.А, КулешоваMogilev State A. Kuleshov UniversityМогилевская областная клиническая больница Витебский государственный ордена Дружбы народов медицинский университетMogilev Regional Clinical Hospital; Vitebsk State Order of Peoples’ Friendship Medical University202428052024213716Copyright © Осипенко А.Н., Точило С.А., Марочков А.В., 20242024Осипенко А.Н., Точило С.А., Марочков А.В.Osipenko A.N., Tachyla S.A., Marochkov A.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.gsmu.by/jour/article/view/2634

В обзоре представлены данные различных исследователей, в том числе и авторов данной статьи, касающиеся роли нарушения обмена липидов, а также причин, их вызвавших, в формировании синдрома полиорганной недостаточности (СПОН). Приводятся сведения о вкладе интенсивного липолиза в жировых депо в развитие иммунного ответа, а также в формирование острого респираторного дистресс-синдрома (ОРДС) и острого повреждения почек. Характеризуется вклад интенсивного липолиза в процесс изменения состава жирных кислот плазмы крови. Показано значение интенсификации окислительного метаболизма арахидоновой кислоты крови в развитии расстройств кровообращения и возникновении системного воспаления. Описано изменение липидного метаболизма эритроцитарных мембран и его влияние на гемодинамику. Охарактеризована связь между нарушением липидного метаболизма, расстройством функции клеточных мембран и их последствиями, включая развитие некротических процессов в тканях. Обращается особое внимание на значение снижения содержания общего холестерина, а также холестерина липопротеинов высокой, низкой и очень низкой плотности в формировании СПОН, в частности, описываются предлагаемые пути влияния дефицита холестерина на прогрессирование органной дисфункции. Приводятся данные об изменении содержания модифицированных липопротеинов, а также фосфолипидов и триглицеридов в плазме крови при СПОН. Отмечается наличие и вероятная роль дефицита плазмалогенов плазмы крови в органных нарушениях при СПОН. Рассматривается вопрос о функционально-метаболической роли дисфункции пероксисом и митохондрий в патогенезе СПОН. Приведено обоснование важности контроля показателей липидного метаболизма при оценке тяжести состояния пациентов с наличием СПОН.

The review presents data from various researchers, including the authors of this article, regarding the role of lipid metabolism disorders, as well as the causes that caused them in the formation of multiple organ dysfunction syndrome (MODS). Information is provided on the contribution of intense lipolysis in fat depots to the development of the immune response, as well as the formation of acute respiratory distress syndrome and acute kidney injury. The contribution of intense lipolysis to the process of changing the composition of fatty acids in blood plasma is characterized. The importance of intensifying the oxidative metabolism of arachidonic acid in the blood in the development of circulatory disorders and the occurrence of systemic inflammation is shown. Changes in lipid metabolism of erythrocyte membranes and its effect on hemodynamics are described. The relevance between disorders of lipid metabolism, dysfunction of cell membranes and their consequences, including the development of necrotic processes in tissues, has been characterized. Particular attention is paid to the importance of reducing the content of total cholesterol, as well as high-, low- and very low-density lipoprotein cholesterol in the formation of MODS, in particular, the proposed ways of influencing cholesterol deficiency on the progression of organ dysfunction are described. Data are provided on changes in the content of modified lipoproteins, as well as phospholipids and triglycerides in the blood plasma during MODS. The presence and probable role of plasma plasmalogen deficiency in organ disorders in MODS is noted. The problem of functional and metabolic role of peroxisome and mitochondria dysfunction in the pathogenesis of MODS is considered. The rationale for the importance of monitoring lipid metabolism parameters when assessing the severity of the condition of patients with MODS is provided.

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