多糖包被在急性呼吸窘迫综合征中的研究进展  

Research progresses of glycocalyx and its role during acute respiratory distress syndrome

作　　者：沈子渊 赵峰[1] 杨翠 丛竹凯 朱曦[1] Shen Zi-yuan;Zhao Feng;Yang Cui;Cong Zhu-kai;Zhu Xi(Department of Intensive Care Medicine,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院危重医学科,北京100191

出　　处：《中国急救医学》2022年第11期1002-1007,共6页Chinese Journal of Critical Care Medicine

基　　金：首都卫生发展科研专项(首发2020-2-4094);国家自然科学基金(82172166);北京市自然科学基金(7212130)。

摘　　要：急性呼吸窘迫综合征(ARDS)是一种较常见的临床危重症,病理表现为急性弥漫性肺泡损伤(DAD)伴肺泡毛细血管通透性增加、肺质量增加和肺组织气体交换能力丧失,保护内皮细胞的结构与功能在ARDS的诊疗过程中日益受到重视。多糖包被是存在于血管内皮细胞管腔面的一层淡蓝色物质,其已被证实通过多种机制维持脉管系统的稳态,多糖包被的降解与ARDS的发生密切相关。本文阐述了多糖包被对人体心血管及炎症反应等方面的保护机制及其降解途径,并总结了目前针对ARDS的肺泡毛细血管多糖包被的保护措施,以期对ARDS的预测及诊疗提供新思路。Acute respiratory distress syndrome(ARDS)is a common clinical critical illness.The pathological manifestations of ARDS are acute diffuse alveolar damage(DAD)with increased alveolar vascular permeability,increased lung weight and the loss of gas exchange capacity in lung tissue,protection of the structure and function of endothelial cells has been paid more and more attention in the diagnosis and treatment of ARDS.Glycocalyx is a light blue substance that exists in the lumen of the endothelium and has been proved to maintain vascular homeostasis through a variety of mechanisms.Degradation of glycocalyx is closely related to the occurrence of ARDS.The current article reviews the protective mechanism and degradation pathway of glycocalyx on cardiovascular and inflammatory responses in humans,and summarizes the current protective measures of glycocalyx in ARDS,in order to provide new ideas for the prediction,diagnosis and treatment of ARDS.

关 键 词：多糖包被 急性呼吸窘迫综合征(ARDS) 肺泡毛细血管 弥漫性肺泡损伤(DAD) 

分 类 号：R563.8[医药卫生—呼吸系统]