重叠综合征患者血管内皮损伤机制及靶向治疗进展  

Advance in mechanism of vascular endothelial injury and targeted therapy in patients with overlap syndrome

作　　者：毕虹[1] 金志贤[1] 周开华[1] 和煦[1] 陈敏[1] 王清[1] 黄照明 BI Hong;JIN Zhi-xian;ZHOU Kai-hua;HE Xu;CHEN Min;WANG Qing;HUANG Zhao-ming(Department of Pneumology, the First Hospital of Kunming Calmette Hospital, Kunming 650224, China)

机构地区：[1]昆明市第一人民医院甘美医院呼吸内科,650224

出　　处：《天津医药》2017年第11期1228-1232,共5页Tianjin Medical Journal

基　　金：国家自然科学基金资助项目(81560010)

摘　　要：重叠综合征(OS)患者病理生理、临床症状较单纯的慢性阻塞性肺疾病(COPD)与阻塞性睡眠呼吸暂停低通气综合征(OSAHS)更复杂,更易并发心血管疾病,使治疗更加困难,预后更差。临床上尚缺乏可明显减缓或阻止OS病程进展及心血管并发症发生的药物。血管内皮受损与心脑血管疾病密切相关。目前,COPD与OSAHS血管内皮损伤及治疗受到广泛关注。本文总结了近年来OS血管内皮损伤机制研究进展,主要包括低氧损伤、炎症损伤、氧化应激损伤及交感神经活性改变;并总结了针对血管内皮损伤的靶向治疗热点,主要为无创呼吸机辅助通气、细胞移植及靶向药物治疗,进一步为临床OS患者的治疗、预后改善提供参考。The changes of pathophysiology and clinical symptoms in patients with overlap syndrome(OS)are more serious than those of chronic obstructive pulmonary disease(COPD)and obstructive sleep apnea hypopnea syndrome(OSAHS).OS is more prone to cardiovascular disease,which the makes treatment more difficult and prognosis worse.There is a lack of drugs that can significantly slow or prevent the progression of OS and cardiovascular complications.The damage of vascular endothelium is closely related to cardiovascular diseases.At present,COPD and OSAHS have received extensive attention in the vascular endothelial injury and the treatment.This article summarizes the progress in the mechanism of injury of vascular endothelium in OS in recent years,including the damage of hypoxia,inflammation,oxidative stress and changes of sympathetic nerve activity,and summarizes targeted therapy for vascular endothelial injury,mainly including non-invasive ventilator,cell transplantation and targeted drug treatment.This study provides theoretical basis for the clinical treatment and prognosis improvement in patients with OS.

关 键 词：肺疾病 慢性阻塞性 睡眠呼吸暂停 阻塞性 内皮 血管 综述 重叠综合征 

分 类 号：R563.9[医药卫生—呼吸系统]