摘要
急性肺损伤(ALI)/成人呼吸窘迫综合征(ARDS)是全身炎性反应综合征在肺部的表现,炎症失控是病变的本质,炎性介质启动了ALI的发生。ALI时常有重症肾上腺皮质功能不全,补充外源性糖皮质激素(GC)可纠正内源性GC的代谢异常,并可通过其受体介导的对多种信号通路的多效性表达,抑制多种细胞因子的转录,减少炎性介质的释放而发挥抗炎、免疫抑制的作用。近年来国内外使用GC治疗ALI的经验表明,"早期使用,中小剂量,延长时间,逐渐减量"的用药方案可望缩短病程,改善患者预后,但其确切的疗效有待于进一步系统研究证实。
Acute lung injury（ALI）/adult respiratory distress syndrome（ARDS） are the manifestation of systemic inflammatory response syndrome（SIRS） in the lung, out-of-control inflammation is the essence of the disease, inflammatory mediators started ALI, often accompanied by critical illness-related corticosteroid insuf- ficiency（ CIRCI）, to supply the exogenous glucoeorticoid（GC） can correct the metabolic abnormalities of the endogenous glucocorticoid,and through its receptor-mediated expression of multiple signaling pathways, GC can inhibit the transcription factor of many cells, reduce releasing of inflammatory mediators, and play an im- portant role in anti-inflammation and immune suppression on defense response of the body. In recent years, experiences of corticosteroids for ALI at home and abroad shows the regimen, which is ＂early use, low and medium-doses, prolonged therapeutic times, gradually reducing＂ ,is expected to shorten the duration of symptoms and improve outcomes of ALI patients. But the benefits in ALI should be further confirmed by an adequately powered systematic research.
出处
《医学综述》
2012年第14期2243-2245,共3页
Medical Recapitulate
关键词
急性肺损伤
成人呼吸窘迫综合征
全身炎性反应综合征
糖皮质激素
Acute lung injury
Adult respiratory distress sydrome
Systemic inflammatory response syn- drome
Glucocorticoid
