表面活性剂在支气管肺病理发病机制中的作用

Q4 Medicine Meditsinskiy Sovet Pub Date : 2023-10-12 DOI:10.21518/ms2023-340
M. A. Kharitonov, Yu. V. Rudakov, V. V. Salukhov, N. I. Voloshin
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引用次数: 0

摘要

肺表面活性物质是肺的重要结构,具有降低肺泡表面张力、促进呼吸、防止气道塌陷、保证气道通畅、抵抗感染和病理环境因素等基本生命功能。虽然表面活性剂体内平衡的紊乱通常被认为是早产儿呼吸窘迫综合征的原因,但已经确定的是,成人的许多肺部疾病都伴随着表面活性剂体内平衡的明显紊乱。然而,支气管肺病理学的临床前和临床研究往往忽视了肺表面活性物质的定性或定量组成变化在疾病症状的发病和发展中的潜在作用。在许多肺部疾病中,这些对体内平衡的干扰是因还是果仍有争议。本综述将研究目前关于肺表面活性物质的组成、主要功能及其功能障碍在肺科医生、治疗师和康复专家实践中最常遇到的支气管肺疾病发病机制中的作用的数据,特别是成人急性呼吸窘迫综合征,包括与新型冠状病毒感染相关的急性呼吸窘迫综合征、各种病因的肺炎及其后果、支气管哮喘、慢性阻塞性肺病。本文综述了目前外源性表面活性剂制剂替代疗法的最佳实践,并展望了上述疾病形式中表面活性剂体内平衡失调的药理调节。
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Role of surfactant in the pathogenesis of bronchopulmonary pathology
Pulmonary surfactant is an important structure of the lungs, providing basic vital functions: reducing alveolar surface tension and facilitating breathing, preventing collapse of the airways and ensuring their patency, protection against infections and pathological environmental factors. Although disturbances of surfactant homeostasis are usually considered in the context of respiratory distress syndrome in preterm infants, it has been established that many lung diseases in adults are accompanied by significant disturbances of surfactant homeostasis. However, preclinical and clinical studies of bronchopulmonary pathology too often overlook the potential role of changes in the qualitative or quantitative composition of pulmonary surfactant in the pathogenesis and development of disease symptoms. In many lung diseases, whether these disturbances in homeostasis are cause or effect remains contravertial field. This review will examine current data on the composition, main functions of pulmonary surfactant and the role of its dysfunction in the pathogenesis of the most frequently encountered bronchopulmonary diseases in the practice of pulmonologists, therapists and rehabilitation specialists, in particular, such as acute respiratory distress syndrome in adults, including associated with a new coronavirus infection, pneumonia of various etiologies and their consequences, bronchial asthma, chronic obstructive pulmonary disease. The review presents the current best practices of replacement therapy with exogenous surfactant preparations and the prospects for pharmacological modulation of surfactant homeostasis disorders in the above nosological forms.
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来源期刊
Meditsinskiy Sovet
Meditsinskiy Sovet Medicine-Medicine (all)
CiteScore
0.70
自引率
0.00%
发文量
418
审稿时长
6 weeks
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