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脓毒性心肌病是脓毒性休克早期出现的可逆性心肌抑制,主要表现为左心室扩张、射血分数降低,7~10 d可恢复正常。虽然病程可逆,但其在脓毒症中的发生率逐年升高,且具体机制尚不明确,炎症反应、线粒体功能障碍、细胞凋亡等病理生理过程起重要作用。脓毒性心肌病涉及机体与病原之间的相互作用,过程复杂。目前针对脓毒性心肌病的治疗以脓毒性休克的治疗指南为基础,以血流动力学指标为依据,以改善组织灌注为导向,同时辅以心脏保护治疗。该文就脓毒性心肌病病理生理机制及治疗两个方面进行综述。“,”Sepsis-induced cardiomyopathy(SICM)is a reversible cardiac insufficiency in the early stage of sepsis, and mainly manifests as left ventricular dilation, decreased ejection fraction, and recovery within 7~10 days.Although it is reversible, the incidence and mortality in sepsis are high.The specific mechanism is still unclear.Inflammatory reaction, mitochondrial dysfunction, apoptosis and other pathophysiological processes play an important role.Its process is complex and involves the interaction between organism and pathogen.The management of SICM is still based on the etiologic treatment of septic shock guided by hemodynamic monitoring and tissue perfusion, with cardio-protective therapy and specific measures.This review summarizes the literatures on the mechanisms and treatments of SICM.