机械拉伸在肺泡上皮细胞损伤修复中的作用研究进展  

Research progress on the role of mechanical stretch in the injury and repair of alveolar epithelial cells

作　　者：唐心怡 薛皓月 谢永鹏 Tang Xinyi;Xue Haoyue;Xie Yongpeng(Department of Emergency,Lianyungang Clinical College of Nanjing Medical University(the Affiliated Lianyungang Hospital of Xuzhou Medical University,the First People's Hospital of Lianyungang),Lianyungang 222000,Jiangsu,China)

机构地区：[1]南京医科大学连云港临床医学院(徐州医科大学附属连云港医院,连云港市第一人民医院)急诊科,江苏连云港222000

出　　处：《中华危重病急救医学》2025年第1期92-96,共5页Chinese Critical Care Medicine

基　　金：江苏省科技厅社会发展面上项目(BE2020670);江苏省连云港市科技计划社会发展项目(SF2117);江苏省连云港市卫生科技项目(202301)。

摘　　要：机械通气(MV)目前被广泛应用于呼吸衰竭的治疗及麻醉手术中,是危重症患者常用的呼吸支持方法;但MV的不恰当使用会导致呼吸机相关性肺损伤(VILI),严重时甚至会危及患者的生命。肺泡上皮细胞(AEC)具有机械感知和机械转导的功能。生理条件下的机械拉伸对于维持AEC细胞谱系稳态及其正常生理功能是有益的,而过度的机械拉伸则会导致AEC细胞受损。AEC细胞损伤是VILI发生发展的重要环节。了解机械拉伸对AEC细胞的影响对于制定安全有效的MV策略、预防VILI的发生、改善VILI患者临床预后具有至关重要的意义。本文旨在从细胞力学角度,简要阐述AEC细胞的力学特性、AEC细胞对机械拉伸的感知和转导、机械拉伸刺激下AEC细胞损伤及潜在修复机制,以期使临床医生更好地理解MV导致VILI的病理生理学机制,提高临床医生对VILI的认识,为临床MV的使用提供更安全、有效的策略,并为VILI的预防和治疗提供理论依据。Mechanical ventilation(MV)is currently widely used in the treatment of respiratory failure and anesthesia surgery,and is a commonly used respiratory support method for critically ill patients;however,improper usage of MV can lead to ventilator-induced lung injury(VILI),which poses a significant threat to patient life.Alveolar epithelial cell(AEC)has the functions of mechanosensation and mechanotransduction.Physiological mechanical stretching is beneficial for maintaining the lineage homeostasis and normal physiological functions of AEC cells,while excessive mechanical stretching can cause damage to AEC cells.Damage to AEC cells is an important aspect in the occurrence and development of VILI.Understanding the effects of mechanical stretching on AEC cells is crucial for developing safe and effective MV strategies,preventing the occurrence of VILI,and improving the clinical prognosis of VILI patients.From the perspective of cell mechanics,this paper aims to briefly elucidate the mechanical properties of AEC cells,mechanosensation and mechanotransduction of mechanical stretching in AEC cells,and the injury and repair of AEC cells under mechanical stretch stimulation,and potential mechanisms with the goal of helping clinical doctors better understand the pathophysiological mechanism of VILI caused by MV,improve their understanding of VILI,provide safer and more effective strategies for the use of clinical MV,and provide theoretical basis for the prevention and treatment of VILI.

关 键 词：肺泡上皮细胞 呼吸机相关性肺损伤 机械拉伸 Piezo1阳离子通道 RHO/RHO激酶信号通路 YAP/TAZ 

分 类 号：R563[医药卫生—呼吸系统]