中性粒细胞弹性蛋白酶抑制剂在高海拔地区脓毒性相关ARDS的应用前景

ISSN:2705-098X(P)

EISSN:2705-0505(O)

语言:中文

作者
马启霞,刘晓琴
文章摘要
脓毒症相关的急性肺损伤(ALI)/急性呼吸窘迫综合征(ARDS)是由脓毒症诱发的普遍且严重的并发症,具有较高的发病率和死亡率,常发生在肺部感染或肺外部位感染后炎症风暴失控,宿主对感染的异常反应导致肺泡毛细血管内皮损伤、屏障破坏,最终以低氧血症、炎症和非心源性肺水肿为特征的肺损伤。大量研究证实了中性粒细胞弹性蛋白酶在急性肺损伤中起到的关键作用,研究表明中性粒细胞弹性蛋白酶抑制剂的应用大大降低了脓毒症时炎性介质的释放,减少内皮细胞释放,从而保护肺泡屏障功能完整性,减轻急性肺损伤发生率。但是所有研究均基于海平面地区数据而来,高原缺氧本身以原发病或继发性病因参与高原ARDS/MODS的发病机制,因此本文致力于探讨中性粒细胞弹性蛋白酶在高海拔地区的应用前景。
文章关键词
脓毒症;急性呼吸窘迫综合征;中性粒细胞弹性蛋白酶
参考文献
[1] Meyer,N.J.and H.C.Prescott,Sepsis and Septic Shock.New England Journal of Medicine,2024.391(22):p.2133-2146. [2] Shankar-Hari,M.,et al.,Developing a New Definition and Assessing New Clinical Criteria for Septic Shock:For the Third International Consensus Definitions for Sepsis and Septic Shock(Sepsis-3).JAMA:the journal of the American Medical Association, 2016.315(8):p.775-787. [3] Evans,L.,et al.,Executive Summary:Surviving Sepsis Campaign:International Guidelines for the Management of Sepsis and Septic Shock 2021.Critical Care Medicine,2021.49:p.1974-1982. [4] Englert,J.A.,C.Bobba and R.M.Baron,Integrating molecular pathogenesis and clinical translation in sepsis-induced acute respiratory distress syndrome.JCI insight,2019.4(2). [5] Englert,J.A.,C.Bobba and Baron RM,Integrating molecular pathogenesis and clinical translation in sepsis-induced acute respiratory distress syndrome.JCI Insight,2019.4(2). [6] 孙玉景等,糖皮质激素在脓毒症治疗中研究进展.中国老年学杂志,2022.42(17):第4365-4369页. [7] 王喜梅等,脓毒血症的流行病学与临床治疗进展.中华医院感染学杂志,2017.27(15):第3597-3600页. [8] 郑岚等,系统免疫炎症指数联合细胞因子检测在脓毒血症患者中的应用.标记免疫分析与临床,2024.31(5):第855-859页. [9] 张怡牛丹宗媛董道然尹贻明,HVHF治疗对脓毒血症并发ARDS患者血清TNF-α、IL-6、IL-8和IL-10水平的影响.贵阳医学院学报,2016.41(3):第318-321页. [10] 李赋等,肺泡巨噬细胞自噬在急性肺损伤/急性呼吸窘迫综合征中的研究进展.中国急救医学,2024.44(11):第1002-1006页. [11] Iwata,K.,et al.,Effect of Neutrophil Elastase Inhibitor(Sivelestat Sodium)in the Treatment of Acute Lung Injury(ALI)and Acute Respiratory Distress Syndrome(ARDS):A Systematic Review and Meta-Analysis.Internal Medicine,2010.49(22):p.2423-2432. [12] Wen,D.,et al.,Plasma Concentrations of Interleukin-6,C-reactive Protein,Tumor Necrosis Factor-Αand Matrix Metalloproteinase-9 in Aortic Dissection.Clinica Chimica Acta,2011.413:p.198-202. [13] Ahlstrom,B.,et al.,A comparison of impact of comorbidities and demographics on 60-day mortality in ICU patients with COVID-19,sepsis and acute respiratory distress syndrome.Sci Rep,2022.12(1):p.15703. [14] Zhou,X.,et al.,A Narrative Review:The Role of NETs in Acute Respiratory Distress Syndrome/Acute Lung Injury.Int J Mol Sci, 2024.25(3). [15] Ding,Q.,et al.,Clinical Utility of the Sivelestat for the Treatment of ALI/ARDS:Moving on in the Controversy?Intensive care research,2023.3(1):p.12-17. [16] 胡晓玲,陈斯宁与陆珏,中性粒细胞弹性蛋白酶与慢性阻塞性肺疾病关系的研究进展.大众科技,2023.25(1):第123-126,116页. [17] Polverino,E.,et al.,The Role of Neutrophil Elastase Inhibitors in Lung Diseases.Chest,2017.152(2):p.249-262. [18] 寇妍妍与李倩,中性粒细胞弹性蛋白酶对呼吸机相关性肺炎诊断、转归评估价值研究.中国现代药物应用,2021.15(18):第84-86页. [19] 揭志军等,急性肺损伤患者血清中中性粒细胞弹性蛋白酶活性的变化.中华急诊医学杂志,2005.14(6):第497-499页. [20] Furusawa,T.,et al.,The effects of a neutrophil elastase inhibitor on the postoperative respiratory failure of acute aortic dissection.Thorac Cardiovasc Surg,2006.54(6):p.404-7. [21] Bellomo,R.,et al.,The effect of intensive plasma water exchange by hemofiltration on hemodynamics and soluble mediators in canine endotoxemia.Am J Respir Crit Care Med,2000.161(5):p.1429-36. [22] Suda,K.,et al.,Neutrophil elastase inhibitor improves survival of rats with clinically relevant sepsis.Shock,2010.33(5):p.526-31. [23] Okamoto,M.,et al.,[Toxicity study of sodium N-[2-[4-(2,2-dimethylpropionyloxy)phenylsulfonylamino]benzoyl]aminoacetate tetrahy- drate(ONO-5046.Na)(5).6-month repeated dose intravenous toxicity study in dogs with 1-month recovery test].J Toxicol Sci,1998.23 Suppl 3:p.483-501. [24] Kishimoto,M.,et al.,Sivelestat sodium and mortality in pneumonia patients requiring mechanical ventilation:propensity score analysis of a Japanese nationwide database.J Anesth,2017.31(3):p.405-412. [25] Zhou,Y.,et al.,Efficacy and safety of sivelestat sodium for the treatment of inflammatory response in acute Stanford type A aortic dissection:a retrospective cohort study.Journal of thoracic disease,2022.14(10):p.3975-3982. [26] Aikawa,N.and Y.Kawasaki,Clinical utility of the neutrophil elastase inhibitor sivelestat for the treatment of acute respiratory distress syndrome.Ther Clin Risk Manag,2014.10:p.621-9. [27] Endo,S.,et al.,Sivelestat sodium hydrate improves septic acute lung injury by reducing alveolar dysfunction.Research communications in molecular pathology and pharmacology,2006.119(1-6):p.53. [28] Pu,S.,et al.,Effect of Sivelestat Sodium in Patients with Acute Lung Injury or Acute Respiratory Distress Syndrome:a Meta-Analysis of Randomized Controlled Trials.BMC pulmonary medicine,2017.17. [29] 王之舟等,西维来司他钠治疗成人急性呼吸窘迫综合征效果的meta分析.临床药物治疗杂志,2024.22(2):第18-25页. [30] 杨波与金肇权,西维来司他钠联合乌司他丁治疗脓毒症所致急性呼吸窘迫综合征的临床疗效.实用医学杂志,2024.40(5):第621-626页. [31] 洪春巧,张懋与周晓露,西维来司他钠在ICU不同疾病合并ARDS患者中的应用效果.临床合理用药,2024.17(35):第64-66页. [32] 王瑾,周冠华与王助衡,西维来司他钠治疗急性呼吸窘迫综合征患者预后影响因素分析.中国药物与临床,2024.24(22):第1448-1452页. [33] 罗敏等,西维来司他钠治疗COVID-19相关急性呼吸窘迫综合征重症患者的疗效:一项回顾性、单中心、队列研究.南方医科大学学报,2023.43(08):第1259-1267页.
Full Text:
DOI