支气管扩张发病机制的研究进展

Pathogenesis Research in Progress of Bronchiectasis

支气管扩张是由于各种原因引起支气管病理性、永久性扩张,导致反复化脓性感染的气道慢性炎症性疾病,临床表现为长期慢性的咳嗽、咳痰、咯血,反复的细菌感染、疲倦、体质量下降和进行性的气道受损。在病理学方面,支气管黏膜纤毛清除受损,未能充分清除气道中细菌和黏液,导致持续感染、炎症和进一步的气道损伤,进行性气道损伤导致肺通气功能、换气功能障碍,加重了临床症状,最终导致患者出现呼吸衰竭甚至死亡。支气管扩张的发病机制复杂,其可能机制有微生物感染与定植、免疫调节异常、细胞免疫功能受损、黏膜纤毛清除受损、氧化应激所致气道损伤等,那么究竟是单一机制还是多个机制所致疾病的发生和发展?本文对目前支气管扩张发病机制进行综述,期望给目前支气管扩张诊治和以后的临床研究提供新的思路和方向。

Bronchiectasis as a chronic inflammatory disease caused by pathological and permanent dilatation of bronchial trees for various reasons which is a clinical syndrome that usually presents with cough,sputum production and recurrent chest infections,along with other symptoms,such as malaise,chest discomfort,haemoptysis,repeated suppurative infections and weight loss.In terms of pathophysiology,bronchial dilatation leads to impaired mucociliary clearance,and failure to adequately clear bacteria and mucus from the airways leads to persistent infection,inflammation and further airway damage.Progressive airway damage can lead to impaired lung function,worsening symptoms and eventually respiratory failure and death.The pathogenesis of bronchiectasis is complex,an its pathogenesis mainly includes microbial colonization and infection,dysregulated immunity,impaired cellular innate immunity,impaired mucociliary clearance and airway injury in bronchiectasis caused by oxidative stress,etc.So is it a single mechanism or the occurrence and development of diseases caused by multiple mechanisms?Therefore,this article gived a review on the pathogenesis of bronchiectasis,hoping to provide some ideas or directions for the current diagnosis,treatment and future clinical research of bronchiectasis.