血液流变学与急性肺损伤

急性肺损伤(ALI)是指机体遭受严重感染、创伤、休克、化学毒物等打击后出现的以弥漫性毛细血管膜和肺泡损伤为基本病理基础,以肺部炎性细胞浸润、水肿、气体交换障碍为临床特征的一组综合征;其最严重结局或终末阶段即为急性呼吸窘迫综合征(ARDS),死亡率甚高,据多数文献报道约为50%。大量研究表明,ALI/ARDS是一种由各种始动事件引起的全身性急性炎症反应,肺循环障碍为其主要的病理基础,氧化应激则在启动此一病理进程中起重要作用。近十余年,随着生物物理学的研究进展,血液流变学也取得长足进步,已从宏观血液流变学向微观血液流变学发展,开始由细胞水平逐渐深入到亚细胞、分子层面,血液流变学新的理论和技术为循环功能的深入探索提供了重要工具,也将大大加深对ALI/ARDS与肺循环障碍内在联系的认识深度。现将血液流变学进展在ALI/ARDS研究中的应用问题作一综述,以供今后研究和临床工作参考。

Hemorheology and acute lung injury

Acute lung injury(ALI)and its most severe type,acute respiratory distress syndrome(ARDS)are quite frequent complications in critically ill patients with various etiological agents such as severe infection,trauma,shock,poisoning etc.,its severe type,ARDS,is especially responsible for the high mortality which has been around 50%.Studies have shown that ALI/ARDS is part of a acute systemic inflammatory process involving various organs including heart,kidneys,gut,liver,muscle,brain etc.manifested as multi-organ dysfunction.The recent study revealed that main pathological basis of ALI is pulmonary microcirculation dysfunction,while oxidative stress plays an important role in initiating the process of ALI/ARDS.Hemorheology is a newly developed scientific field and has achieved much progress in recent years both in theory and technique with the development of bio-physics,the modern hemorheology has already entered subcellular or molecular level,thereby offers more new measures for the exploration on circulation function.The paper will focus on the research progress of the relationship between hemorheology and ALI/ARDS,which should be quite useful in the further study on the molecular mechanism of ALI/ARDS.