机械通气所致肺损伤生物学标志探究进展VIP免费

题目：机械通气所致肺损伤的生物学标志的研究进展单位：上海市瑞金医院作者：沈富毅张富军审校：薛庆生摘要：对于急性肺损伤（acute lung injury,ALI ）、急性呼吸窘迫综合症(acute respiratory distress syndrome,ARDS)患者，正压机械通气可以挽救生命。然而， 大量实验及临床资料证明，临床医生如何设定通气方案包括潮气量、 PEEP及气道平台压等，将影响患者肺损伤的严重性、预后和死亡率。近年来，固有免疫应答及炎症反应在机械通气所致肺损伤（ ventilator-induced lung injury，VILI ）发病机制中的作用得到了广泛的研究。目前的研究结果倾向于炎症反应是VILI 发生的主要机制。研究发现，血浆、血清及肺泡灌洗液内的细胞因子和趋化因子是 VILI 的主要生物学标志。关键词：机械通气，肺损伤，VILI ，炎症反应，生物学标志Abstract: For patients with ALI(acute lung injury) or ARDS(acute respiratory distress syndrome),the positive pressure mechanical ventilation can save their lives.However,a lot of experimental studies and clinical datas have proved that how the clinicians set the ventilatory strategies(including the tidal volume,the positive end-expiratory pressure and the plateau airway pressure,etc) can affect the severity of the lung injury,the outcomes and the mortality.In recent years,the effects of the inherent immunity and the inflammation have been widely studied in pathogenesy of the ventilator-induced lung injury(VILI).The investigators find that the inflammation is the main mechanism in VILI and the cytokines and chemokines are the main biological markers in plasm,serum and bronchoalveolar lavage fluid. Keywords:ventilator-induced lung injury,inflammation,biological marker机械通气是治疗急性肺损伤(ALI )与急性呼吸窘迫综合征(ARDS)不可缺少的手段之一。 但机械通气和呼吸机的使用过程中，也可能产生或加重肺损伤， 其机理主要与肺组织的过度牵张、萎陷肺泡反复闭合—开放产生的剪力损伤及机械通气诱导产生炎症介质的大量释放密切相关1。下文将对机械通气所致肺损伤（VILI ）生物学标志的研究进展做一综述。临...