紧密连接蛋白occludin在机械通气诱发肺损伤中作用的研究进展

Research progress of tight junction protein occludin＇s function in ventilator-induced lung injury

背景急性肺损伤（acutelunginjury，ALI）／急性呼吸窘迫综合征（acuterespiratorydistresssyndrome，ARDS）是指由心源性以外的各种肺内外致病因素所导致的急性、进行性呼吸衰竭。其发病机制错综复杂，迄今为止尚未完全阐明。机械通气诱发肺损伤（ventilationinducedlunginjury，VILI）是其中重要的一类，它是指应用呼吸机过程中由于机械通气诸多因素和肺部原发病共同作用导致的肺组织损伤。肺损伤过程中肺泡膜的完整性破坏及通透性的改变是根本原因，细胞连接维持肺泡膜完整性和通透性，它主要包括黏附连接（adherentiunction，AJ）和紧密连接（tightiunction，TJ），其中TJ在维持肺泡黏膜上皮机械屏障和肺泡膜通透性中起着更加重要的作用，TJ蛋白主要包括ZO-1、跨膜蛋白（elaudin）和闭锁蛋白（occludin）等。目的通过对TJ蛋白occludin在机械通气诱发肺损伤中作用的研究来指导临床实践。内容探讨TJ蛋白occludin在机械通气诱发肺损伤中的作用。趋向明确连接蛋白在VILI中的作用，为临床上早期预防与治疗VILI提供理论依据。

Background The acute acute lung injury （ALI）/aeute respiratory distress syndrome （ARDS） is a common clinical disorder eharacterised by injury to the alveolar epithelial and endothelial harriers of the lung, acute inflammation, and protein rich pulmonary edema leading to acute respiratory failure. The pathogenesis is complicated, it has not been fully elucidated so far. Ventilator-induced lung injury （VILI） refers to the process of applying ventilator jointly lead to pulmonary edema due to mechanical ventilation and many other factors of primary lung. It has been considered that the integrity of the alveolar membrane damage and permeability changes is the fundamental reason. Adherent junction （AJ） and tight junction （TJ） are the important structures of maintenance of epithelial barrier and permeability, and the role of TJ is more important. TJ protein includes Zo-I, claudin, oeeludin and so on. Objective It is of great significance to clarify the effects of TJ protein oeeludin in VILI. Content This review mainly discusses the research progress of TJ protein occludin in VILI. Trend Realized the role of TJ protein occludin in VILI, then provided a theoretical basis for early prevention and treatment of ventilator-induced pulmonary edema and lung injury in clinical.