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中华肺部疾病杂志(电子版) ›› 2024, Vol. 17 ›› Issue (03) : 488 -492. doi: 10.3877/cma.j.issn.1674-6902.2024.03.033

综述

急性主动脉夹层并发急性肺损伤的研究新进展
廖江荣1, 吴秀琳2,(), 陈光春3, 郭亮4, 吕慈2, 蔡俊5, 陈夕1,()   
  1. 1. 563000 贵州,贵州航天医院呼吸及危重症医学科
    2. 400038 重庆,陆军(第三)军医大学第一附属医院老年医学与特勤医学科
    3. 563000 贵州,贵州航天医院胸外科
    4. 400037 重庆,陆军(第三)军医大学第二附属医院呼吸及危重症医学科
    5. 400000 重庆,武警重庆总队医院检验科
  • 收稿日期:2024-03-07 出版日期:2024-06-25
  • 通信作者: 吴秀琳, 陈夕
  • 基金资助:
    遵义市呼吸疾病快速精准诊断创新人才团队(遵市科合HZ字〔2022〕178号)

New progress in studying acute aortic dissection complicated by acute lung injury

Jiangrong Liao, Xiulin Wu(), Guangchun Chen   

  • Received:2024-03-07 Published:2024-06-25
  • Corresponding author: Xiulin Wu
引用本文:

廖江荣, 吴秀琳, 陈光春, 郭亮, 吕慈, 蔡俊, 陈夕. 急性主动脉夹层并发急性肺损伤的研究新进展[J]. 中华肺部疾病杂志(电子版), 2024, 17(03): 488-492.

Jiangrong Liao, Xiulin Wu, Guangchun Chen. New progress in studying acute aortic dissection complicated by acute lung injury[J]. Chinese Journal of Lung Diseases(Electronic Edition), 2024, 17(03): 488-492.

急性主动脉夹层(acute aortic dissection, AAD)是危及生命的心血管疾病,发病急,病情危重,病死率高。全球每年AAD的发病率约为5~30/10万人,住院病死率达34%[1,2]。AAD常在手术前就发生多器官损害,如急性肺损伤(acute lung injury, ALI)、氧合损伤(oxygenation injury, OI)、心力衰竭、肾和肝功能不全、神经功能缺损等,导致不良结局。研究表明,大约35 %的AAD患者被诊断为并发ALI [3]。急性Stanford A型主动脉夹层(acute stanford type a aortic dissection, TAAD)术前并发ALI的发生率为34.9%~53.8%, 30%~50%的AAD患者存在术后ALI[4,5]。目前临床对其发病机制仍不明确,因此加强认识其发病机制对于早期识别及防治AAD并发ALI具有重要的临床意义。

1
Yang Ming. Acute lung injury in aortic dissection:new insights in anesthetic management strategies[J]. J Cardiothorac Surg, 2023, 18(1): 147.
2
Guo ZJ, Yang YW, Zhao MM, et al. Preoperative hypoxemia in patients with type A acute aortic dissection: a retrospective study on incidence, related factors and clinical significance[J]. J Thorac Dis, 2019, 11(12): 5390-5397.
3
Harris KM, Nienaber CA, Peterson MD, et al. Early mortality in type A acute aortic dissection: Insights from the international registry of acute aortic dissection[J]. JAMA Cardiol, 2022, 7(10): 1009-1015.
4
周文君,赤文萃,李万顺,等. 急性主动脉夹层合并急性肺损伤危险因素的研究进展[J]. 中国胸心血管外科临床杂志2021, 28(12): 1503-1507.
5
Liu N, Zhang W, Ma W, et al. Risk factors for hypoxemia following surgical repair of acute type A aortic dissection[J]. Interact Cardiovasc Thorac Surg, 2017, 24 (2): 251-256.
6
Huang X, Xiu H, Zhang S, et al. The role of macrophages in the pathogenesis of ALI/ARDS[J]. Mediators Inflamm, 2018, 2018: 1264913.
7
Gordon DR. The Berlin definition of acute respiratory distress syndrome:The ARDS definition task force[J]. JAMA, 2012, 307(23): 2526-2533.
8
Bernard GR, Artigas A, Brigham KL, et al. Report of the American-European Consensus conference on acute respiratory distress syndrome: definitions, mechanisms, relevant outcomes, and clinical trial coordination. Consensus Committee[J]. J Crit Care, 1994, 9(1): 72-81.
9
Qi TJ, Xu F, Yan XX, et al. Sulforaphane exerts anti-inflammatory effects against lipopolysaccharide-induced acute lung injury in mice through the Nrf2/ARE pathway[J]. Int J Mol Med, 2016, 37(1): 182-188.
10
Sun B, Jing Xiao, Sun XB, et al. Notoginsenoside R1 attenuates cardiac dysfunction in endotoxemic mice: an insight into oestrogen receptor activation and PI3K/Akt signalling[J]. Brit j pharmacol, 2013, 168(7): 1758-1770.
11
Wu Z, Ruan YL, Chang JX, et al. Angiotensin Ⅱ is related to the acute aortic dissection complicated with lung injury through mediating the release of MMP9 from macrophages[J]. Am J Transl Res, 2016, 8(3): 1426-1436.
12
Zhao XM, Bie MJ. Preoperative acute lung injury and oxygenation impairment occurred in the patients with acute aortic dissection[J]. BMC Cardiovasc Disord, 2022, 22(1): 129.
13
Wu Z, Wang Z, Dai F, et al. Dephosphorylation of Y685-VE-cadherin involved in pulmonary microvascular endothelial barrier injury induced by angiotensin Ⅱ[J]. Mediators Inflamm, 2016, 2016: 8696481.
14
Wu Z, Jinxing C, Wei R, et al. Bindarit reduces the incidence of acute aortic dissection complicated lung injury via modulating NF-κB pathway[J]. Exp ther med, 2017, 14(3): 2613-2618.
15
Hua M, Gao P, Fang F, et al. IL-6 enhances the phagocytic function of mouse alveolar macrophages by activating the JAK2/STAT3 signaling pathway[J].Cellular and Molecular Immunology, 2024, 40(1): 13-18.
16
Li Q, Ye WX, Huang ZJ, et al. Effect of IL-6-mediated STAT3 signaling pathway on myocardial apoptosis in mice with dilated cardiomyopathy[J]. Eur Rev Med Pharmacol Sci, 2019, 23(7): 3042-3050.
17
Xu S, Pan X, Mam L, et al. Phospho-Tyr705 of STAT3 is a therapeutic target for sepsis through regulating inflammation and coagulation[J]. Cell Commun Signal, 2020, 18(1): 104.
18
Ren W, Wang ZW, Wu ZY, et al. JAK2/STAT3 pathway was associated with the protective effects of IL-22 on aortic dissection with acute lung injury[J]. Dis markers, 2017: 2017: 1917804.
19
Lu Z, Liu R, Huang E, et al. MicroRNAs: New regulators of IL-22[J]. Cellular Immunology, 2011, 304-305: 1-8.
20
Wang L, Zhuang LW, Rong HF, et al. MicroRNA-101 inhibits proliferation of pulmonary microvascular endothelial cells in a rat model of hepatopulmonary syndrome by targeting the JAK2/STAT3 signaling pathway[J]. Mol med rep, 2015, 12(6): 8261-8267.
21
Liu Q, Xie W, Wang Y, et al. JAK2/STAT1-mediated HMGB1 translocation increases inflammation and cell death in a ventilator-induced lung injury model[J]. Lab Invest, 2019, 99(12): 1810-1821.
22
Zeng Z, Zhang K, Cai J, et al. Associations of high-mobility group box 1 and receptor for advanced glycation end products with acute lung injury in patient with acute aortic dissection[J]. Rev Assoc Med Bras, 2021, 67(9): 1251-1255.
23
Liu Qd, Guan YL, Yang XF, et al. Perioperative oxygenation impairment related to type a aortic dissection[J]. Perfusion, 2024, 4: 2676591231224997.
24
Yang M. Acute lung injury in aortic dissection : New insights in anesthetic management strategies[J]. J Cardiothorac Surg, 2023, 18(1): 147.
25
Chai YS, Chen YQ, Lin SH, et al. Curcumin regulates the differentiation of naïve CD4+ T cells and activates IL-10 immune modulation against acute lung injury in mice[J]. Biomed Phar-macother, 2020, 125: 109946.
26
Luis Eduardo AD, Douglas SP, Flavio P, et al. VerasPKM2 promotes Th17 cell differentiation and autoimmune inflammation by fine-tuning STAT3 activation[J]. J Exp Med, 2020, 217(10): e20190613.
27
Liu Y, Zou LW, Tang HF, et al. Single-cell sequencing of immune cells in human aortic dissection tissue provides insights into immune cell heterogeneity[J]. Front Cardiovasc Med, 2022, 31(9): 791875.
28
贺宝臣. 外周血Th17细胞、降钙素原在急性A型主动脉夹层病人中的表达与急性肺损伤的关系[J]. 实用老年医学2019, 33(4): 346-350.
29
Mowei S, Li D, Hongtao S, et al. Th1, Th2, and Th17 cells are dysregulated, but only Th17 cells relate to C-reactive protein, D-dimer, and mortality risk in Stanford type A aortic dissection patients[J]. J Clin Lab Anal, 2022, 36(6): e24469.
30
Gao Z, Pei X, He C, et al. Oxygenation impairment in patients with acute aortic dissection is associated with disorders of coagulation and fibrinolysis: a prospective observational study[J]. J Thorac Dis, 201911(4): 1190-1201.
31
MacLaren R, Stringer KA. Emerging role of anticoagulants and fibrinolytics in the treatment of acute respiratory distress syndrome[J]. Pharmacotherapy, 2007, 27(6): 860-873.
32
高志峰,卢家凯,程卫平,等. 急性主动脉夹层围手术期急性肺损伤与TF和TFPI的相关性[J]. 中华胸心血管外科杂志2014, 30(12): 736-740.
33
Gao ZF, Pei X, He C, et al. Oxygenation impairment in patients with acute aortic dissection is associated with disorders of coagulation and fibrinolysis: a prospective observational study[J]. J Thorac Dis, 2019, 11(4): 1190-1201.
34
Poole LG, Massey VL, Siow DL, et al. Plasminogen activator inhibitor-1 is critical in alcohol-enhanced acute lung injury in mice[J]. Am J Respir Cell Mol Biol, 2017, 57: 315-323.
35
刘 健,宋 然,宋朝国,等. 急性A型主动脉夹层患者发生急性肺损伤的影响因素分析[J]. 中国现代医学杂志2021, 31(15): 88-93.
36
Satyam A, Graef ER, Lapchak PH, et al. Complement and coagulation cascades in trauma[J]. Acute Med Surg, 2019, 6(4): 329-335.
37
Ning L, Zou SS, Wang B, et al. Targeting immunometabolism against acute lung injury[J]. Clin Immunol, 2023, 249: 109289.
38
Fan LL, Meng K, Meng FQ, et al. Metabolomic characterization benefits the identification of acute lung injury in patients with type A acute aortic dissection[J]. Front Mol Biosci, 2023, 10: 1222133.
39
Viswan A, Singh C, Rai RK, et al. Metabolomics based predictive biomarker model of ARDS: A systemic measure of clinical hypoxemia[J]. PLOS ONE, 2017, 12(11): e0187545.
40
Zhang Y, Yu W, Han D, et al. L-lysine ameliorates sepsis-induced acute lung injury in a lipopolysaccharide-induced mouse model[J]. Biomed Pharmacother, 2019, 118: 109307.
41
Schumacher T, Benndorf RA. ABC transport proteins in cardiovascular disease-a brief summary[J]. Molecules, 2017, 22(4): 589.
42
Sato T, Shimizu T, Fujita H, et al. GLP-1 receptor signaling differentially modifies the outcomes of sterile vs viral pulmonary inflammation in male mice[J]. Endocrinology, 2020, 161(12): bqaa201.
43
Li J, Zheng J, Jin X, et al. Intestinal barrier dysfunction is involved in the development of systemic inflammatory responses and lung injury in type A aortic dissection: a case-control study[J]. J Thorac Dis, 2022, 14: 3552-3564.
44
Wang YH, Yan ZZ, Luo SD, et al. Gut microbiota-derived succinate aggravates acute lung injury after intestinal ischaemia/reperfusion in mice[J]. Eur Respir J, 2023, 61: 2200840.
45
Zhou D, Wang Q, Liu H. Coronavirus disease 2019 and the gut-lung axis[J]. Int J Infect Dis, 2021, 113: 300-307.
46
Tang J, Xu L, Zeng Y, et al. Effect of gut microbiota on LPS-induced acute lung injury by regulating the TLR4/NF-kB signaling pathway[J]. Int Immunopharmacol, 2021, 91: 107272.
47
Zhao X, Bie M. Predictors for the development of preoperative oxygenation impairment in acute aortic dissection in hypertensive patients[J]. BMC Cardiovasc Disord, 2020, 20: 365.
48
Guo Z, Yang Y, Zhao M, et al. Preoperative hypoxemia in patients with type A acute aortic dissection: a retrospective study on incidence, related factors and clinical significance[J]. J Thorac Dis, 2019, 11(12): 5390-5397.
49
Li DZ, Chen QJ, Sun HP, et al. Mean platelet volume to platelet count ratio predicts in-hospital complications and long-term mortality in type A acute aortic dissection[J]. Blood Coagul Fibrinolysis, 2016, 27(6): 653-659.
50
Pan X, Lu J, Cheng W, et al. Independent factors related to preoperative acute lung injury in 130 adults undergoing Stanford type-A acute aortic dissection surgery: a single-center cross-sectional clinical study[J]. J Thorac Dis, 2018, 10(7): 4413-4423.
51
罗伟康,肖 纯. 急性主动脉夹层并发低氧血症的相关危险因素研究进展[J]. 海南医学2023, 12: 1811-1815.
52
Andualem AA, Yesuf KA. Incidence and associated factors of postoperative hypoxemia among adult elective surgical patients at Dessie Comprehensive Specialized Hospital: An observational study[J]. Ann Med Surg (Lond), 2022, 78: 103747.
53
Li J, Gao PF, Xu YX, et al. Probiotic saccharomyces boulardii attenuates cardiopulmonary bypass-induced acute lung injury by inhibiting ferroptosis[J]. Am J Transl Res, 2022, 14: 5003-5013.
54
Wang DF, Zhang C, Han D, et al. Risk factors of hypoxemia after Stanford type A acute aortic dissection stent implantation[J]. J Cardiovascular Pul Dis, 2021, 40(1): 53-55, 63.
55
魏 红,董铁立,杨现会,等. 盐酸戊乙奎醚注射液在主动脉夹层手术中对肺缺血再灌注的影响[J]. 中华医学杂志2018, 98(10): 777-780.
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