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国际呼吸杂志
国际呼吸杂志

白春学

半月刊

1673-436X

guojihuxi@163.com

0311-86266873

050017

河北省石家庄市中山东路361号

国际呼吸杂志/Journal International Journal of Respiration北大核心CSTPCD
查看更多>>1981年创刊，中华医学会、河北医科大学主办。本刊原名国外医学呼吸系统分册，系医学科技期刊，中华医学会系列刊物之一。办刊宗旨：贯彻、执行国家的政策法规和规范标准，坚持理论与实践、普及与提高相结合的原则，促进国内、外学术交流。报道内容：介绍国内、外呼吸疾病的新动态、新成果、新技术和新经验。主要栏目：诊治指南、专家述评、专家共识、专家笔谈、论著、综述、继续教育、呼吸介入、研究报道、专题讲座、临床经验、病例分析、病例报告、病例讨论、呼吸读片等。读者对象：呼吸科、急诊科、ICU、小儿科、老年科、胸外科、微创治疗中心、睡眠中心、变态反应科的医师和护士，以及从事呼吸领域基础研究和临床研究的科技工作者。
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    美泊利珠单抗治疗嗜酸性肉芽肿性多血管炎的疗效及安全性分析

    林文敏欧昌星陈丹丹刘美君...
    192-199页
    查看更多>>摘要：目的 研究美泊利珠单抗用于治疗嗜酸性肉芽肿性多血管炎(EGPA)患者的疗效及安全性。 方法 本研究为非随机对照实验，采用目的抽样法收集2021年8月至2023年8月在广州医科大学附属第一医院接受美泊利珠单抗治疗的20例EGPA患者资料，通过比较治疗前后的伯明翰血管炎活动度评分(BVAS)、血嗜酸性粒细胞计数及百分比、第1秒用力呼气容积占预估值百分比(FEV1%pred)、口服皮质类固醇激素(OCS)维持用量等指标的差异，评估美泊利珠单抗治疗EGPA的疗效，并观察患者用药期间的安全性。 结果 20例EGPA患者女性17例85.0%(17/20)，年龄42.0(30.8，52.5)岁。治疗4个月后总应答率为85.0%，血嗜酸性粒细胞计数由0.7(0.5，1.5)×109/L下降至0.1(0，0.1)×109/L(Z＝3.88，P<0.001)，FEV1%pred由70.4%(49.7%，85.2%)上升至79.9%(72.0%，101.5%)(Z＝2.24，P＝0.025)，FeNO由80.0(35.0，111.5)ppb下降至51.6(28.3，65.4)ppb，(Z＝2.54，P＝0.011)，OCS由25.0(16.3，30.0) mg/d减量为5.9(5.0，7.5)mg/d(Z＝3.83，P<0.001)。5例患者治疗12个月后上述临床指标较治疗前仍有明显改善。进一步比较5例美泊利单抗标准剂量治疗组(300 mg组)和15例非标准剂量组(100 mg组)治疗前后临床指标变化，治疗4个月后，2组在降低BVAS评分及血嗜酸性粒细胞计数、改善肺功能指标(FEV1%pred)、减少OCS用量方面差异无统计学意义(均P>0.05)。20例患者共接受125次注射治疗，仅有1例次在注射美泊利珠单抗后出现皮疹，可耐受。 结论 美泊利珠单抗对于治疗EGPA疗效较好，可减少OCS维持治疗剂量，改善肺功能，且安全性良好，未观察到严重不良事件，标准剂量组与非标准剂量组都可以改善EGPA的症状并减少OCS用量。 Objective To investigate the efficacy and safety of mepolizumab in the treatment of patients with eosinophilic granulomatosis with polyangiitis (EGPA). Methods This was a non-randomized controlled trials study.Purposive sampling was used to collect data of 20 EGPA patients treated with mepolizumab at the First Affiliated Hospital of Guangzhou Medical University from August 2021 to December 2023.The study evaluated the differences in Birmingham Vasculitis Activity Score (BVAS), blood eosinophil count and percentage, forced expiratory volume in one second (FEV1) as a percentage of predicted value (FEV1%pred), and oral corticosteroid (OCS) maintenance dose before and after treatment to assess the efficacy of mepolizumab and observe the safety of patients during treatment. Results Among the 20 patients with EGPA, there were 17 females (85.0%), with an average age of 42.0 (30.8, 52.5)years.After 4 months of treatment, the total response rate was 85.0%.The blood eosinophil count decreased from 0.7 (0.5, 1.5)×109/L to 0.1 (0, 0.1)×109/L (Z=3.88, P<0.001). The FEV1%pred increased from 70.4% (49.7%, 85.2%) to 79.9% (72.0%, 101.5%)(Z=2.24, P=0.025). The fractional exhaled nitric oxide (FeNO) level decreased from 80.0 (35.0, 111.5) ppb to 51.6 (28.3, 65.4) ppb (Z=2.54, P=0.011). The oral corticosteroid (OCS) dosage was reduced from 25.0 (16.3, 30.0) mg/d to 5.9 (5.0, 7.5) mg/d (Z=3.83, P<0.001). After 12 months of treatment, 5 patients still show significant improvement inthe above clinical indicators compared to those before treatment.The clinical indicator changes before and after treatment between the standard dose group (300 mg/4 weeks) and the non-standard dose group (100 mg/4 weeks) were compared.The results showed no significant statistical difference in reducing BVAS scores, decreasing blood eosinophil counts, improving lung function indicators (FEV1%pred), and reducing OCS dosage after 4 months of treatment (P>0.05). Among the 20 patients, a total of 125 injections were administered, with only one instance of rash occurring post-injection of mepolizumab, which was tolerable. Conclusions Mepolizumab has shown good efficacy in the treatment of EGPA, canreduce the maintenance dose of OCS andimprove lung function, and demonstrates good safety with no observed serious adverse events.Both the standard dose group and the non-standard dose group can effectively manage the symptoms and reduce the OCS usage in EGPA.

    嗜酸性肉芽肿性多血管炎美泊利珠单抗分子靶向治疗治疗结果

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    11例鹦鹉热衣原体肺炎的临床特征分析

    张丽萍田瑞雪可爱华颜卫峰...
    200-206页
    查看更多>>摘要：目的 探讨鹦鹉热衣原体肺炎的临床特点。 方法 本研究为观察性研究，采用非随机抽样法收集2021年4月至2023年7月北京市海淀医院呼吸与危重症医学科收治的11例鹦鹉热衣原体肺炎患者的病例资料，包括一般信息、流行病学史、临床症状、实验室检查、胸部影像学资料、治疗方案和预后等指标。分析其临床特点。 结果 7例患者有鸟类接触史。临床症状为高热、咳嗽、呼吸困难、肌痛等。10例外周血白细胞总数正常，C反应蛋白均明显升高。10例谷丙转氨酶及谷草转氨酶升高。D-二聚体、N-端B型钠尿肽前体均升高。5例肌酸激酶升高，4例肌酐升高，8例有低钠血症。胸部影像学典型特征为肺实变影，可见支气管充气征。4例见磨玻璃影，5例有胸腔积液。5例合并呼吸衰竭，3例发展为重症肺炎，2例出现急性呼吸窘迫综合征，2例合并横纹肌溶解。所有患者经宏基因组二代测序确诊。确诊后10例以四环素类为基础治疗，8例应用多西环素，2例应用奥马环素。1例单用阿奇霉素。所有患者好转出院。 结论 鹦鹉热衣原体肺炎可合并横纹肌溶解，部分进展为重症肺炎，出现急性呼吸窘迫综合征，累及多器官。宏基因组二代测序能快速确诊。以四环素类为基础的综合治疗，疗效良好。 Objective To explore the clinical features of Chlamydia psittaci (C.psittaci) pneumonia. Methods This study was an observational study.Non-random sampling method was used.Clinical data of 11 patients with C. Psittaci pneumonia in the department of Rrespiratory and Critical Care Medicine of Beijing Haidian Hospital from April 2021 to July 2023 were collected and analyzed.The clinical data included general information, epidemiology history, clinical symptoms, laboratory examination, chest imaging, treatment plan and prognosis etc. Results Seven cases had a history of bird contact.High fever, cough, dyspnea, and muscle pain were common clinical manifestations.Blood routine test showed that 10 patients had normal white blood cell count.C-reactive protein level was significant elevated in all cases.Ten cases had increased alanine aminotransferase and aspartate aminotransferase.D-dimer and N-terminal B-type natriuretic peptide precursor were both increased.Five cases had increased creatine kinase, 4 cases had elevated creatinine, and 8 cases had hyponatremia.Chest imaging typically showed lung consolidation with bronchial inflation sign.Four patients were with ground-glass opacity, 5 patients were complicated with pleural effusion, 5 cases were combined with respiratory failure, 3 cases progressed to severe pneumonia, 2 patients were complicated with acute respiratory distress syndrome, and 2 patients were complicated with rhabdomyolysis.The pathogenic diagnosis was confirmed by metagenomic next-generation sequencing in all patients.After diagnosis, 10 patients were treated based on tetracyclines, 8 patients were treated with doxycycline, 2 patients were treated with omacycline, and 1 patient was treated with azithromycin alone.All patients were discharged from the hospital after their condition improved. Conclusions Chlamydia psittaci pneumonia may combine rhabdomyolysis.Some cases may progress to severe pneumonia, combine acute respiratory distress syndrome, and have multiple organ involvement.Metagenomic next-generation sequencing can quickly and accurately diagnose the disease.The combined treatment based on tetracyclines shows good effect.

    肺炎鹦鹉热鹦鹉热衣原体宏基因组二代测序

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    脓毒症相关急性呼吸窘迫综合征患者血清焦亡蛋白的表达及意义

    刘佳丽苑萌韩宝华谭俊晖...
    207-211页
    查看更多>>摘要：目的 研究脓毒症相关急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)患者血清焦亡蛋白的变化及意义。 方法 本研究为病例对照研究。采用非随机抽样法，选择2020年1月至2022年12月河北北方学院附属第一医院收治的脓毒症200例患者作为研究对象，根据脓毒症患者是否合并ALI/ARDS分为脓毒症非ALI/ARDS组(116例)与脓毒症ALI/ARDS组(84例)，根据脓毒症ALI/ARDS患者28 d预后情况分为生存组(52例)和死亡组(32例)。检测血清焦亡蛋白半胱氨酸天冬氨酸蛋白水解酶1(Caspase-1)、Gasdermin-D(GSDMD)水平，采用logistic回归分析脓毒症ALI/ARDS患者死亡的影响因素，采用受试者工作特征(ROC)曲线分析脓毒症ALI/ARDS患者死亡的预测指标。 结果 脓毒症ALI/ARDS组患者的血清Caspase-1、GSDMD-N水平均高于脓毒症非ALI/ARDS组。分别为Caspase-1[(1 181.25±320.31) ng/L比(913.58±201.46) ng/L]；GSDMD-N (8.87±1.59) μg/L比(7.14±1.24) μg/L；(均P<0.05)；死亡组脓毒症ALI/ARDS患者的血清Caspase-1、GSDMD-N、肌酐及急性生理和慢性健康状况Ⅱ(APACHEⅡ)评分均高于存活组。分别为Caspase-1 [(1 411.53±325.78) ng/L比(1 039.55±220.2) ng/L；GSDMD-N (10.35±1.55) μg/L比(7.97±0.67) μg/L；APACHE Ⅱ [(27.50±3.75)分比(21.15±4.70)分。(均P<0.05)；logistic回归分析显示，血清Caspase-1、GSDMD-N、APACHEⅡ评分是脓毒症ALI/ARDS患者死亡的影响因素(均P<0.05)；ROC曲线分析显示，血清Caspase-1(95%CI：0.76～0.93)、GSDMD-N(95%CI：0.88～1.00)及APACHEⅡ评分(95%CI：0.76～0.95)对脓毒症ALI/ARDS患者的死亡具有预测效能，三项指标联合(平行试验)预测的敏感度和特异度分别为96.88%和92.31%。 结论 脓毒症相关ALI/ARDS患者血清焦亡蛋白Caspase-1、GSDMD-N显著增加，且其联合APACHEⅡ评分对患者死亡具有良好的预测效能。 Objective To study the changes and significance of serum pyroptosis protein of patients with sepsis associated acute lung injury (ALI)/acute respiratory distress syndrome (ARDS). Methods This was a case-control study.Using non-random sampling method, 200 cases of sepsis patients admitted to the First Affiliated Hospital of Hebei North University from January 2020 to December 2022 were selected as the study subjects.Sepsis patients were divided into sepsis non-ALI/ARDS group (n=116) and sepsis ALI/ARDS group (n=84) according to whether they were combined with ALI/ARDS.Sepsis ALI/ARDS patients were further divided into survival group (n=52) and death group (n=32) according to the 28 d prognosis.The levels of cysteinyl aspartate specific proteinase-1 (Caspase-1) and Gasdermin-D (GSDMD) in serum were detected.The influencing factors of death in patients with sepsis ALI/ARDS were analyzed by logistic regression and the predictive indicators of death were analyzed by receiver operating characteristic (ROC) curve. Results The levels of serum Caspase-1 and GSDMD-N in sepsis ALI/ARDS group were higher than those in sepsis non-ALI/ARDS group.Caspase-1 was (1 181.25±320.31) ng/L vs (913.58±201.46) ng/L GSDMD-N was (8.87±1.59) μg/L vs (7.14±1.24) μg/L.(all P<0.05). The levels of serum Caspase-1, GSDMD-N, creatinine, and acute physiological and chronic health evaluation Ⅱ (APACHEⅡ) scores of sepsis ALI/ARDS patients in the death group were higher than those in the survival group Caspase-1 was (1 411.53±325.78 ) ng/Lvs (1 039.55±220.2) ng/L GSDMD-N was (10.35±1.55) μg/L vs (7.97±0.67) μg/L APACHE Ⅱ was (27.50±3.75) vs (21.15±4.70) points.(all P<0.05). Logistic regression analysis showed that serum Caspase-1, GSDMD-N, and APACHEⅡ scores were the influencing factors for the death of sepsis ALI/ARDS patients (allP<0.05). ROC curve analysis showed that serum Caspase-1 (95%CI: 0.76-0.93), GSDMD-N (95% CI: 0.88-1.00), and APACHEⅡ scores (95% CI: 0.76-0.95) were effective in predicting the death of sepsis ALI/ARDS patients, and the combined prediction sensitivity and specificity of the three indexes were 96.88% and 92.31% respectively. Conclusions Serum pyroptosis protein Caspase-1 and GSDMD-N significantly increase in patients with sepsis associated with ALI/ARDS, and combined with APACHEⅡ score the two factors show a good predictive efficacy on patient death.

    脓毒症急性肺损伤急性呼吸窘迫综合征细胞焦亡

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    经支气管镜肺活检在肺部病变伴急性低氧性呼吸衰竭临床诊断中的应用价值

    金亦凡汪泱张晓辉毛静宇...
    212-217页
    查看更多>>摘要：目的 探讨经支气管肺活检(TBLB)对伴急性低氧性呼吸衰竭(AHRF)肺部病变的诊断价值及其影响因素。 方法 本研究为回顾性横断面研究，采用非随机抽样的方法，选取2015年9月至2023年3月苏州大学附属第一医院呼吸与危重症医学科重症病房(RICU)收治的115例伴AHRF的原因不明肺部病变且接受TBLB的患者为研究对象。记录患者一般人口学资料、影像学资料、病理结果及TBLB术后24 h内发生的不良事件，采用logistic回归分析确定TBLB对此类患者诊断价值的影响因素。 结果 通过TBLB，115例患者中有48例(41.74%)获得指向性诊断，67例(58.26%)未能获得指向性病理诊断的患者中有29例借助其他方式获得了明确诊断。logistic回归分析显示，女性、氧合指数>200 mmHg、恶性病变有利于TBLB获得指向性病理诊断，而影像学呈现亚实性病变不利于TBLB获得指向性诊断。TBLB术后24 h并发症总发生率为15.65%(18/115)，严重并发症低于1%。 结论 TBLB对伴急性低氧性呼吸衰竭的恶性肺部病变的诊断价值较高，但对良性病变诊断价值有限，总体安全性良好。 Objective To explore the diagnostic value of transbronchial lung biopsy (TBLB) in pulmonary diseases complicated with acute hypoxemic respiratory failure (AHRF) and to clarify the associated factors. Methods This was a retrospective cross-sectional study, and non-random sampling was used.A total of 115 patients with unexplained pulmonary infiltrates with AHRF who underwent TBLB in Respiratory and Critical Care Unit of the First Affiliated Hospital of Soochow University from September 2015 to March 2023 were enrolled.The general demographic data, imaging data, pathological results, and adverse events within 24 h after TBLB were recorded.Logistic regression analysis was used to determine the factors affecting the diagnostic value of TBLB in such patients. Results Using TBLB, 48 patients (41.74%) obtained definite pathological diagnosis and the left 67 (58.26%) patients didn′t obtain the definite diagnosis.Of 67 undiagnosed cases, 29 patients (58.26%) were clearly diagnosed by other methods later.According to logistic regression analysis, females, oxygenation index >200 mmHg, and malignant lesions are favor factors for definite pathological diagnosis while subsolid lesions tend to lead to indefinite pathological diagnosis.Within 24 h after TBLB, adverse events occurred in 15.65% (18/115) patients, with the incidence of serious adverse events <1%. Conclusions TBLB shows high diagnostic value for malignant lung lesions with acute hypoxic respiratory failure, but has limited diagnostic value for benign lesions, and the overall safety is good.

    低氧呼吸功能不全支气管镜检查肺部病变诊断价值

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    伏立康唑治疗出芽短梗霉肺炎1例并文献复习

    谢成凯苏远薛芳
    218-223页
    查看更多>>摘要：出芽短梗霉是一种条件致病菌，属于腐生性暗色真菌，可累及全身多个系统，但出芽短梗霉引起的肺部感染相对少见。本文报道1例接受多线治疗的肺癌患者通过肺泡灌洗液宏基因组二代测序诊断为出芽短梗霉肺炎。该患者并无呼吸系统症状，仅在胸部CT复查时发现双肺散在磨玻璃影，同时双手皮肤可见暗红色皮疹。经过伏立康唑抗真菌治疗后，该患者双肺和手部病灶均明显好转。文献回顾表明，两性霉素B、伊曲康唑、伏立康唑、氟康唑、5-氟胞嘧啶和泊沙康唑对出芽短梗霉感染均有较好疗效，其中皮肤感染以伊曲康唑效果最佳。鉴于出芽短梗霉感染的罕见性，目前仍无统一的抗真菌治疗标准，因此本例的诊疗经过可为出芽短梗霉肺炎的诊治提供一定的参考价值。 Aureobasidium pullulans (A.pullulans) is a conditional pathogen belonging to saprophytic dark fungi, which can affect multiple systems in the body.However, pulmonary infections caused by A. pullulans are relatively rare.This article reports a case of A. pullulans pneumonia diagnosed through metagenomic next-generation sequencing of alveolar lavage fluid in a patient receiving multimodal therapy for lung cancer.The patient presented no respiratory symptoms, with only scattered ground glass opacities detected upon CT reexamination, along with dark red rashes visible on the skin of both hands.Following antifungal treatment with voriconazole, the lung and hand lesions of the patient both showed significant improvement.Literature review suggests that amphotericin B, itraconazole, voriconazole, fluconazole, 5-fluorocytosine, and posaconazole are all effective in treating A. pullulans infections, with itraconazole most effective for skin infections.Given the rarity of A. pullulans infections, there is currently no standardized antifungal treatment.Therefore, the diagnostic and therapeutic experience of this case may provide some reference value for the management of A. pullulans pneumonia.

    出芽短梗霉肺炎真菌感染伏立康唑

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    鸟肠球菌所致社区获得性肺炎1例报道及文献复习

    孙淑琪李猛房雪洁卢孔渺...
    224-228页
    查看更多>>摘要：鸟肠球菌，经常从鸡粪中分离出来(因此而得名)，最初由于Q群抗原的存在而被称为"Q群链球菌"。鸟肠球菌很少从临床微生物送检标本中分离出来，因此对这种细菌引起的感染性疾病的临床特征知之甚少。本文报道从1例以胸痛伴发热为首发症状的58岁男性患者的胸腔积液中分离出鸟肠球菌，并复习了涉及鸟肠球菌的相关文献。 Enterococcus avium (E.avium), so named because it is often isolated from chicken manure.It was originally called Group Q Streptococcus due to the presence of Group Q antigens.E.avium is rarely isolated from clinical microbiological specimens, so little is known about the clinical characteristics of the infectious patients caused by this bacterium.Therefore, little is known about the clinical characteristics of this infectious disease caused by bacteria.In this paper, Enterococcus avium was isolated from the pleural effusion of a 58-year-old male patient with chest pain and fever as the first symptom, and the related literature involving Enterococcus avium was reviewed.

    糖尿病胸腔积液鸟肠球菌

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    黄酮类化合物在肺部疾病治疗中的研究进展

    李建妍陈敬华李琪薛芳...
    229-234页
    查看更多>>摘要：黄酮类化合物是多酚类化合物，广泛存在于不同植物中，具有多种生物学特性。近几年的研究表明，黄酮类化合物对肺部疾病产生积极的影响，如抗炎、抗氧化、抗菌和抗病毒等作用。本文旨在综述黄酮类化合物的分类及其在肺部疾病治疗中的作用，以期为肺部疾病的治疗提供帮助。 Flavonoids are polyphenolic compounds, widely found in different plants and with a variety of biological properties.In recent years, studies have shown that flavonoids have positive effects on lung diseases, such as anti-inflammatory, antioxidant, antibacterial, and antiviral effects.This article aims to review the classification of flavonoids and their role in lung diseases, in order to provide help for the treatment of pulmonary diseases.

    肺疾病黄酮类化合物抗炎抗氧化抗菌抗病毒

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    游离脂肪酸受体在肺部疾病中的研究进展

    陈敬华李建妍李琪王秋红...
    235-240页
    查看更多>>摘要：游离脂肪酸受体(FFAR)是一类具有多功能性的G蛋白偶联受体，参与细胞内信号传导，调节细胞凋亡、炎症反应、免疫反应和能量代谢等生物学过程。近年来，国内外多项研究发现，FFAR在肺部疾病中发挥着重要作用，有望成为防治呼吸系统疾病的潜在研究靶点。本文对FFAR在哮喘、肺部感染、急性肺损伤、慢性阻塞性肺疾病、特发性肺纤维化等疾病发展中的作用及机制作一综述，以期为呼吸系统疾病的防控、干预提供新的方向。 Free fatty acid receptors (FFAR) are a class of multifunctional G protein-coupled receptors that are involved in intracellular signaling, regulating apoptosis, inflammatory response, immune response, energy metabolism, and other biological processes.In recent years, a large number of studies have found that FFAR play an important role in lung diseases.So FFAR are expected to become a potential target for preventing and treating respiratory diseases.This reviewaims to summarize the possible role of FFAR inasthma, lung infection, acute lung injury, chronic obstructive pulmonary disease (COPD), idiopathic pulmonary fibrosis, and other pulmonary diseases.It is expected to open up new avenues for the control and treatment of these respiratory diseases.

    肺疾病游离脂肪酸受体G蛋白耦联受体抗炎作用

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    肥胖型支气管哮喘与脂质代谢相关作用机制及研究进展

    张凤芹刘辉国薛芳
    241-245页
    查看更多>>摘要：支气管哮喘(哮喘)是一种常见的慢性异质性气道炎症疾病，气道高反应性和可逆性气道阻塞及气道重塑是其主要病理特征。肥胖作为体内脂肪过多沉积引起的代谢疾病，已成为不可忽视的全球公共卫生问题。随着肥胖人口的不断增加，肥胖型哮喘的患病率也呈逐年上升趋势。2014年全球哮喘防治倡议指南已将肥胖型哮喘作为一种新的哮喘表型。肥胖是一种典型的脂质代谢相关疾病，近年研究发现哮喘的发生发展与脂质代谢有一定的关联。本文将讨论脂质代谢在肥胖相关哮喘发生发展中的作用。 Bronchial asthma (asthma) is a prevalent chronic heterogeneous airway inflammatory disease characterized by airway hyperresponsiveness.Reversible airway obstruction and airway remodeling are the primary pathological features.Obesity, a metabolic disorder resulting from excessive accumulation of body fat, has evolved into an undeniable global public health concern.With the continuous growth of obese population, the prevalence of obesity-related asthma has been increasing year by year.In 2014, the Global Initiative for Asthma guidelines recognized obesity-related asthma as a new asthma phenotype.Obesity is a typical lipid metabolism-related disorder, and recent research has unveiled an association between lipid metabolism and the initiation and progression of asthma.This article will explore the role of lipid metabolism in the initiation and progression of obesity-related asthma.

    哮喘肥胖脂质代谢

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    阻塞性睡眠呼吸暂停综合征损伤内皮细胞糖萼及危害的研究进展

    肖文涵王凌云王晓芝薛芳...
    246-248页
    查看更多>>摘要：阻塞性睡眠呼吸暂停综合征(OSAS)是发病率较高、合并症较多的呼吸系统疾病，由于肥胖和老龄化的增加，OSAS的患病率也在持续攀升。OSAS患者在睡眠过程中发生循环性缺氧-复氧事件会导致系统性炎症并导致肺动脉高压，但OSAS导致肺动脉压升高的机制尚不明确。本文综述了OSAS通过损伤肺血管内皮细胞糖萼导致肺动脉高压的可能机制，为应用药物抑制血管内皮细胞糖萼的损伤从而延缓肺动脉高压的发生和发展提供思路。 Obstructive sleep apnea syndrome (OSAS) is a respiratory disease with high incidence rate and more complications.Due to the increase of obesity and aging, the prevalence of OSAS continues to rise.The occurrence of cyclic hypoxia reoxygenation events during sleep in OSAS patients can lead to systemic inflammation and pulmonary hypertension, but the mechanism is not yet clear.This article reviews the possible mechanism of OSAS causing pulmonary arterial hypertension by damaging the glycocalyx of pulmonary vascular endothelial cells, providing ideas for the application of drugs to inhibit the damage of glycocalyx of vascular endothelial cells, so as to delay the occurrence and development of pulmonary arterial hypertension.

    睡眠呼吸暂停,阻塞性内皮细胞糖萼血管重塑肺动脉高压

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