低氧性肺动脉高压的肺血管重建机制研究进展

Research advances in pulmonary vascular remodeling mechanism of hypoxic pulmonary hypertension

低氧性肺动脉高压(hypoxic pulmonary hypertension,HPH)与慢性缺氧有关,导致肺心病甚至死亡。低氧性肺血管收缩和肺血管重建(pulmonary vascular remodeling,PVR)通常认为是HPH的两个阶段,前者更强调早期血管收缩,而PVR才是造成血管舒张药无效的主要原因。既往认为PVR是炎症反应导致,但目前更强调多方面、多因子的共同结果。文章主要从细胞因子、氧化应激、细胞内外离子及细胞自噬和凋亡等在HPH进程中的作用出发,介绍目前对HPH治疗的研究进展,提出未来研究方向的猜想。作为一种不可逆的致死性疾病,肺动脉高压(pulmonary arterial hypertension,PAH)一直是当下肺移植相关研究的热点问题,但PAH类型多,且不同类型的PAH形成机制各不相同。文章综述了HPH的PVR形成机制及对应治疗方案。

Hypoxic pulmonary hypertension(HPH)is often caused by lung diseases such as chronic obstructive pulmonary dis-ease,which ultimately leads to pulmonary heart disease.It is currently believed that hypoxic pulmonary vasoconstriction(HPV)and pulmonary vascular remodeling(PVR)are two main stages of HPH whereas PVR is the main cause of ineffective vasodilators.PVR was thought to be caused by an inflammatory response,but nowadays it was considered as the common results of multiple factors.This re-view focuses on the role of cytokines,oxidative stress,intracellular and extracellular ions,autophagy and apoptosis in the HPH process.We introduces the current research achievements on HPH treatment,and proposes conjectures for future research directions.As an irre-versible lethal disease,pulmonary arterial hypertension(PAH)has been a hot topic in current lung transplantation research,but there are many types of PAH while different types of PAH formation mechanisms are different.This review summarized the progress in mech-anism of PVR and corresponding treatments.