Ang-2与ALI/ARDS血管外肺水的关系及临床意义

摘要

急性肺损伤(ALI)和急性呼吸窘迫综合征(ARDS)是由肺部和全身疾病引起的毛细血管内皮细胞和肺泡上皮细胞损伤造成弥漫性肺间质及肺泡水肿导致的急性低氧性呼吸功能不全或衰竭.血管生成素2(Ang-2)是一个前炎症细胞因子,血循环中高水平的Ang-2导致血管通透性增高,引起血管渗漏.Ang-2能够导致ALI/ARDS患者毛细血管通透性增加,与血管外肺水具有正相关性,循环中Ang-2越高氧合指数越差,是预测ALI/ARDS发展和预后的一个指标.Ang-2阻滞剂能够降低血管通透性和改善肺功能障碍程度,有针对性的以Ang-2 为靶向的干预治疗则可能为ALI/ARDS的治疗提供了一种新的思路与手段.%Acute lung injury (ALI) and its most severe extreme of the acute respiratory distress syndrome (ARDS) refer to increased -permeability pulmonary edema caused by a variety of pulmonary or systemic insults. Angiopoietin -2 (Ang -2 ) appears to have pro -inflammatory properties by increasing vascular leakage. The circulating Ang - 2 is associated with pulmonary permeability oedema and the severity of ALI/ARDS. High Ang - 2 level correlated with impaired pulmonary gas exchange and high mortality for ALI/AlRDS. Although further studies with larger sample sizes will be needed to confirm these results, high Ang- 2 in critically ill patients with ALI/ARDS is associated with a poor outcome.Ang- 2 blockers can reduce vascular permeability and improve the degree of pulmonary dysfunction.These data suggest that antagonism of Ang -2 may provide a future novel therapeutic target for ARDS.