肺表面活性物质在支气管哮喘中的研究进展

195 9年Avery和Mead首先发现新生儿呼吸窘迫综合症(NRDS)患者存在肺表面活性物质 (pulmonarysurfactant,PS)合成不足 ,引起医学界的重视 ,随后又证实成人呼吸窘迫综合症(ARDS)患者肺中PS活性降低 ,更促使学者对PS进行深入的研究。目前 ,已充分认识PS对肺脏发挥呼吸功能的重要性 ,对其形态结构、化学成分、生理功能、合成、分泌及代谢过程有较清楚的认识。在NRDS中 ,PS替代疗法已取得明显进展。 1990年Enhorning从理论上推论出哮喘发作可能与PS相对不足有关 ,随后的研究表明PS与哮喘的关系密切 ,因而成为哮喘研究的一个新热点。…     

体外循环与肺表面活性物质

体外循环（ＣＰＢ）术后的呼吸功能不全有较高的发生率。近年研究认为ＣＰＢ术后内源性肺表面活性物质（ＰＳ）的异常变化很可能是造成术后呼吸功能不全的重要原因。ＣＰＢ术后肺的病理生理变化与成人型呼吸窘迫综合征十分近似，应用外源性ＰＳ治疗成人型呼吸窘迫综合征收到较好效果。因此，理论上ＰＳ治疗ＣＰＢ术后的呼吸功能不全也应该有效。本就ＰＳ体内组成及其功能、ＣＰＢ对ＰＳ的影响、ＣＰＢ术后临床应用外源性ＰＳ的现状     

肺表面活性物质与哮喘

肺表面活性物质能维持肺泡的稳定性，并能防止液柱在小气道中形成，保持气道通畅，在维持气道低阻力中有重要作用。哮喘时由于血浆蛋白渗出及各种水解酶的作用，ＰＳ功能下降，血浆蛋白对ＰＳ活性有明显的抑制。ＰＳ功能下降严重时，又会促进蛋白渗出。补充外源性ＰＳ、可使哮喘症状缓解，肺功能改善，ＰＳ与哮喘的关系，值得深入研究。     

体外循环与肺表面活性物质

体外循环(CPB)术后的呼吸功能不全有较高的发生率。近年研究认为CPB术后内源性肺表面活性物质(PS)的异常变化很可能是造成术后呼吸功能不全的重要原因。CPB术后肺的病理生理变化与成人型呼吸窘迫综合征十分近似。应用外源性PS治疗成人型呼吸窘迫综合征收到较好效果。因此,理论上PS治疗CPB术后的呼吸功能不全也应该有效。本文就PS体内组成及其功能、CPB对PS的影响、CPB术后临床应用外源性PS的现状和今后展望加以简要介绍。     

肺表面活性物质治疗呼吸窘迫综合征临床应用进展

1980年滕原用人工合成的肺表面活性物质(PS)治疗未成熟儿呼吸窘迫综合征(RDS)取得了良效,以后迅即在世界范围内研究和应用,展示了广阔的前景。近年来,我国已有报告自制PS治疗新生儿型和获得性RDS(NRDS、ARDS)。现作一综述。 一、PS的成分、制剂和用法 1986年Yu报告PS中磷脂占80％、中性脂肪10％、蛋白质10％。     

新生儿呼吸窘迫综合征早期应用肺表面活性物质治疗的观察

目的探讨肺表面活性物质对新生儿呼吸窘迫综合征(NRDS)的治疗效果。方法将100例NRDS患儿随机分为治疗组50例和对照组50例,两组均给予机械通气等常规治疗,治疗组在此基础上给予气管内滴入肺表面活性物质,剂量为100 mg/kg。结果治疗组存活率高于对照组,(P<0.05);治疗组通气时间明显低于对照组(P<0.05);治疗组治疗后血气分析与对照组同项比较,(P均<0.05或<0.01);治疗组治疗后各时段机械通气参数FiO2、VEI、MAP与对照组同项比较,(P均<0.05或<0.01)。结论肺表面活性物质对NRDS疗效满意,值得推广。     

肺表面活性物质与哮喘的关系

肺表面活性物质与哮喘的关系毋永正方凤李强肺表面活性物质（ｐｕｌｍｏｎａｒｙｓｕｒｆａｃｔａｎｔ，ＰＳ）是德国生理学家ＶａｎＮｅｅｒｇａａｒｄ在１９２９年发现的，当时仅认为它是存在于肺泡气液交界，减低表面张力，防止呼气末肺萎陷的一种代谢较为稳定的脂蛋白...     

不同剂量肺表面活性物质在新生儿呼吸窘迫综合征中的临床应用

目的 不同剂量的肺表面活性物质在新生儿呼吸窘迫综合征(NRDS)患儿中的应用效果.方法 选取2015年6月至2020年6月内我院收治的47例NRDS患儿,分为高剂量组25例和低剂量组22例,采用固尔苏,高剂量组患儿给予200 mg/kg,低剂量组患儿给予100 mg/kg,比较两组患儿的氧合指数、康复效果以及并发症等....     

肺表面活性物质在急性肺损伤/急性呼吸窘迫综合征中的研究进展

急性肺损伤／急性呼吸窘迫综合征（ALI／ARES）时肺表面活性物质的成分、功能等均发生变化，研究这些变化对防治ALI／ARDS的发生、发展及预后，都有十分重要的意义。本文综述了肺表面活性物质在ALI／ARDS中的组成成分、代谢、功能改变以及治疗方面的研究进展，为该领域的深入研究提供参考。     

树突状细胞在支气管哮喘中的作用研究进展

支气管哮喘是由多种免疫细胞和炎性细胞因子参与发病的免疫系统性疾病.在支气管哮喘免疫过程发生的初始和维持阶段,树突状细胞对于过敏原的识别,摄取和提呈,CD4+T辅助细胞的分化和活化,以及气道变态反应和机体免疫耐受等方面发挥关键作用.通过干预树突状细胞在支气管哮喘发病机制中的作用,来达到治疗支气管哮喘的目的,已经成为目前指导临床用药的研究热点.     

Compositional and functional changes of pulmonary surfactant in a guinea-pig model of chronic asthma

Recent studies have found that severe surfactant dysfunction occurs during an asthma attack, but the changes in surfactant in a guinea-pig model of chronic asthma have not been studied. We therefore analysed the surfactant recovered from guinea-pigs after repeated inhalation of ovalbumin to see if the surfactant recovered from chronic asthmatic lungs would be intrinsically altered. Guinea pigs immunized through repeated inhalation of aerosolized ovalbumin (OA) were exposed to the antigen once a week for a month. Twenty-four hours after the last challenge the alveolar wash was recovered. We calculated saturated phosphatidylcholine (Sat-PC) and total protein (TP) pool sizes in alveolar spaces. Surfactant subtype conversion of large aggregate surfactant (LA) to small aggregate surfactant was studied in vitro by means of the surface area cycling technique. The phospholipid composition of LA was analysed by thin layer chromatography and the surface activity of LA was also determined. We found decreased surfactant pool sizes, decreased ratio of Sat-PC to TP in alveolar lavages in asthma groups, and surface activity of the surfactant recovered from asthmatic lungs to be inferior to that of the controls. Accelerated surfactant subtype conversion in vitro was also noted in the lungs of asthmatic animal models. In addition, the changes in phospholipid compositions which were similar to the pattern of acute lung injury suggested that alveolar inflammation might be involved in the pathogenesis of chronic asthma. These results indicate that surfactant is intrinsically abnormal in chronically asthmatic lungs.     

The role of anticholinergic bronchodilators in adult asthma and chronic obstructive pulmonary disease

Our renewed interest in anticholinergic bronchodilator therapy has been sparked by the development of safe yet effective quaternary anticholinergic compounds including ipratropium bromide, oxitropium and atropine methonitrate. These agents offer gradual and sustained bronchodilatation to patients with asthma and to patients with COPD. However, their role in the maintenance treatment of these two diseases differs significantly. In asthma, the anticholinergic drugs have useful additive properties when used with adrenergic drugs or theophylline. They may be a particularly useful component of combination regimens in patients with disease of more than mild severity and in older patients. The combination of inhaled adrenergic and anticholinergic drugs is also useful in the acute setting for acute exacerbations of asthma. In chronic obstructive lung disease, the anticholinergic compounds offer greater bronchodilatation than adrenergic drugs for the majority of patients. Thus, the inhaled anticholinergic drugs may be considered as useful initial choices in the chronic maintenance therapy of COPD.