急性呼吸窘迫综合征肺泡上皮屏障损伤的研究进展

Research progress on the damage to alveolar epithelial barrier of acute respiratory distress syndrome

肺泡上皮屏障和肺微血管内皮屏障是公认的肺部两大生理屏障。近年来逐渐认识到肺损伤过程中,肺泡上皮屏障比肺微血管内皮屏障具有更强的抵抗力,因此促进肺泡上皮屏障的修复对急性呼吸窘迫综合征(ARDS)患者肺损伤的改善极为重要,而这一治疗又必须建立在对ARDS肺泡上皮屏障损伤的具体机制深入研究的基础上。肺表面活性物质、紧密连接、钠水转运系统作为肺泡上皮屏障的主要成分,ARDS时对这些成分的直接破坏以及炎症细胞和介质的活化、释放导致的间接破坏,都造成它们的结构基础、成分以及功能发生改变,肺泡上皮屏障受到严重损害,进而肺水肿液渗出。因此本文将从这几大主要成分着手,对ARDS肺泡上皮屏障的损伤作一简要综述。

Alveolar epithelial barrier and pulmonary microvascular endothelial barrier are recognized as the two physi-ological barriers of the lung. In recent years, we grow aware that the alveolar epithelial barrier has stronger resistance to lung injury than the pulmonary microvascular endothelial barrier, so it is very important to promote the repairment of alveolar epithelial barrier for the improvement of lung injury in ARDS patients, such treatment must be built on the ba-sis of the in-depth research on the damage mechanism to alveolar epithelial barrier of ARDS. The pulmonary surfac-tant, tight junction, sodium and water transport system as the main components of the alveolar epithelial barrier, during the occurence and development of ARDS, the direct damage to these components and the indirect damage which is caused by activation and release of inflammatory cells and mediators, lead to change in their structural basis, composi-tion and function, and the alveolar epithelial barrier is severely damaged, pulmonary edema fluid is flooded. The paper will make a brief overview about the damage to alveolar epithelial barrier of ARDS from these major components.