肺损伤的干细胞治疗  

Stem cell therapy in lung injury

作　　者：张琦 帅训军[2] 侯念果[2] 艾登斌[2] Zhang Qi;Shuai Xunjun;Hou Nianguo;Ai Dengbin(Graduate School of Taishan Medical University,Taian 271000;Department of Anesthesiology,Qingdao Municipal Hospital,Shandong Province,Qingdao Clinical Anesthesia Research Center,Qingdao 266000,China)

机构地区：[1]泰山医学院研究生处,泰安271000 [2]山东省青岛市市立医院麻醉科,山东省青岛市临床麻醉研究中心,青岛266000

出　　处：《中国组织化学与细胞化学杂志》2018年第3期268-272,共5页Chinese Journal of Histochemistry and Cytochemistry

基　　金：青岛市医疗卫生优秀人才培养项目(青卫科教字[2014])

摘　　要：急性肺损伤(acute lung injury,ALI)是一种起病迅速的非心源性、双肺炎症浸润综合征,晚期进展至高致死性急性呼吸窘迫综合征(acute respiratory distress syndrome,ARDS),是重症患者死亡的第一杀手。ALI/ARDS病理特征:肺泡-毛细血管受损,炎性、嗜中性粒细胞积累,释放炎性细胞因子致弥漫性肺损害,剧烈炎症反应导致肺结构畸形,通气受限、阻碍气体交换、限制患者运动、降低生活质量及住院病人转归。ALI/ARDS病死率50%,成年人病死率高达22%,目前尚无有效纠正难治性低氧血症、持续性呼吸衰竭的治疗方法。ALI/ARDS患者需终生依赖机械通气,住院病人对机械通气的敏感性多器官功能最终发生障碍,提高政府医疗财务成本。治疗潜力强大的间充质干细胞(mesenchymal stem cells,MSC),可从胎儿的肺、脂肪、脐索和成人骨髓获得。MSC治疗ALI/ARDS的关键在于旁分泌可溶性细胞因子:调节免疫应答同时改变上皮、内皮对损伤的反应。此文就干细胞治疗肺损伤的核心机制及其突出特点进行综述。Acute lung injury(ALI)is a rapid onset non-cardiogenic,bilateral lung inflammatory response which progresses to acute respiratory distress syndrome(ARDS)in late stages and remains highly fatal.ALI/AR DS pathological features included neutrophil infihration and severe inflammatory reaction induced diffuse lung lesions,such as alveolar-capillary damages,obstructed ventilation,and reduced gas exchange,which lim it patient activities,reduce q iiality of life,and increase hospitalization.The ALI/AR DS mortality rate is 50%on average and around 22%in adults.Currently there is no effective treatment for refractory hypoxemia and persistent respiratory failure.ALI/AR DS patients need to rely on mechanical ventilation fo r life,and eventually develop mechanical ventilation sensitized m ulti-organ malfunctions.These increase government financial burdens.Mesenchymal stem cells(MSCs)obtained from fetal lxrng,fat,um bilical cord,or adult bone marrow can have huge therapeutic potentials.The key to MSC treatment of ALI/ARDS is paracrine soluble cytokines which regulate the immune response while alter the responses of epithelium and endothelium to injury.This article reviews the core mechanisms of stem cell therapy fo r lung injury and its prominent features.

关 键 词：干细胞 肺 急性呼吸窘迫综合征 神经内分泌 微囊泡 

分 类 号：R563[医药卫生—呼吸系统]