低氧性肺动脉高压中低氧性肺血管收缩的作用

Effect of hypoxic pulmonary vasoconstriction on hypoxic pulmonary hypertension

高海拔低氧环境下,持续发生的低氧性肺血管收缩(hypoxic pulmonary vasoconstriction,HPV)能够诱导低氧性肺动脉高压(hypoxic pulmonary hypertension,HPH)的发生和发展。HPV是机体对低氧环境的一种生理反射机制,是肺组织特有的生理现象。但是在高原低氧环境下,HPV的持续发生会促进肺血管重构,导致右心室肥厚,从而加重肺泡缺氧的程度,造成缺氧的恶性循环,进而导致肺水肿、肺心病等重度高原病的发生。HPH早期出现HPV,慢性期形成难以逆转的低氧性肺血管重塑。因此,明确HPV的发生机制以及其在HPH中的作用,能够为高原病的防治提供靶点和思路;HPV发生时,及时、有效的治疗也能够为重度高原病的预防奠定基础。但是目前的研究,尚未能对HPV的发生机制和其在HPH中扮演的角色做一个清晰、全面的阐明。该文将对近年HPH中HPV的相关研究做一综述,旨在为该领域内的研究者以及HPH的临床治疗方面提供参考。

Sustained hypoxic pulmonary vasoconstriction( HPV)as experienced at high altitude can lead to hypoxic pulmonary hypertension( HPH). HPV,a special physiological phenomenon of lung,is the physiological reflex of organism in hypoxic environment. However,in high altitude hypoxic environment,the sustained HPV can lead to pulmonary vascular remodeling and right ventricular hypertrophy,at the same time,the degree of hypoxia in alveoli can be aggravated. Vicious circle of hypoxia is formed,further causing the severe high altitude sickness such as pulmonary edema and pulmonary heart disease. HPV appears in preliminary of HPH,but in the chronic phase,irreversible hypoxic pulmonary vascular remodeling forms. Therefore,studying the mechanism of HPV and the effect of HPV in HPH can provide targets and ideas for the prevention and treatment of high altitude sickness. Additionally, in preliminary stage of HPV,prompt treatment is critical for the prevention of high altitude sickness. However,the mechanism of HPV and its roles in HPH are still not fully elucidated in current studies. This paper summarizes the studies about HPV in HPH of recent years,aiming to provide references for researchers and clinical treatment in this research field.