肺表面活性物质的成分和功能研究现状  

Research advances in the composition and function of pulmonary surfactant

作　　者：罗可人 唐军 Luo Keren;Tang Jun(Department of Pediatrics,Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, West China Second University Hospital, Sichuan University, Chengdu 610041, Sichuan Province, China)

机构地区：[1]四川大学华西第二医院儿科出生缺陷与相关妇儿疾病教育部重点实验室,成都610041

出　　处：《中华妇幼临床医学杂志（电子版）》2019年第2期137-142,共6页Chinese Journal of Obstetrics & Gynecology and Pediatrics(Electronic Edition)

基　　金：国家自然科学基金资助项目(81300524;81330016;81630038);国家科技部重大专项项目(2017YFA0104200);四川省科技厅计划项目(2016TD0002);国家临床重点专科(儿科新生儿专业)建设项目(1311200003303)~~

摘　　要：肺表面活性物质(PS)已经被临床常规应用于临床治疗新生儿呼吸窘迫综合征(NRDS)。PS是由脂类和各种肺表面蛋白(SP)构成的复合物。近年基础和临床研究对PS的组成成分及其功能具有更深入的认识。PS复杂的脂质成分塑造了其独特的物理属性。SP-A、-D不仅是PS的成分,还分布于肺外组织,可防御各种病原体,并且具有维持免疫稳态的作用。各种PS天然制剂在成分和性质上均存在差异,这也使其对NRDS患儿的治疗疗效、预后等各异,但是哪种PS天然制剂更具有优势,则迄今尚无定论。为了避免PS天然制剂可能导致的传染性疾病发生风险与免疫排斥反应风险及降低药物的经济成本,PS人工制剂的研发已成为热点。目前有关PS成分及其功能的研究多聚焦于SP-B、-C及其在NRDS发病机制中的作用,而本研究涉及过去少有关注的PS脂质成分与其他SP组成。笔者拟对PS的成分和功能进行全面、详实论述,同时介绍最新PS人工合成制剂,旨在为PS治疗NRDS患儿的临床应用提供新认识。Pulmonary surfactant (PS) has been routinely used to treat neonatal respiratory distress syndrome (NRDS). PS is a complex composed of lipids and various surfactant protein (SP). In recent years, basic and clinical studies have gained a deeper understanding of the composition of PS and the function of each component. The complex lipid composition of PS shapes its unique physical properties. SP-A and SP-D are not only the components of PS, but also distribute in the extrapulmonary tissues to defend against various pathogens and maintain the immune homeostasis. There are differences in the composition and properties of various kinds of natural preparations of PS, which results in different manifestations in terms of the efficacy and prognosis of NRDS patients. However, there is still no conclusion as to which natural preparation of PS has more advantages. In order to avoid the infection risk and immune rejection reactions risk of PS natural preparations and reduce the economic cost of drugs, the research and development of PS artificial preparations have become a hot spot. At present, studies on the composition and function of PS mostly focus on SP-B and SP-C and their roles in the pathogenesis of NRDS. This study involves PS lipid components and other types of SP, which have received little attention before. The composition and function of PS are comprehensively and fully discussed. At the same time, the latest PS artificial preparations are introduced, which provides a new understanding for the clinical application of PS in treating NRDS infants.

关 键 词：肺表面活性物质相关蛋白质类 呼吸窘迫综合征 新生儿 主成分分析 凝集素类 功能 药用制剂 婴儿 新生 

分 类 号：R722.1[医药卫生—儿科]