Zemans Rachel L, Matthay Michael A
Department of Medicine, University of California, San Francisco, California, USA.
Crit Care. 2004 Dec;8(6):469-77. doi: 10.1186/cc2906. Epub 2004 Jun 30.
Clearance of pulmonary edema fluid is accomplished by active ion transport, predominantly by the alveolar epithelium. Various ion pumps and channels on the surface of the alveolar epithelial cell generate an osmotic gradient across the epithelium, which in turn drives the movement of water out of the airspaces. Here, the mechanisms of alveolar ion and fluid clearance are reviewed. In addition, many factors that regulate the rate of edema clearance, such as catecholamines, steroids, cytokines, and growth factors, are discussed. Finally, we address the changes to the alveolar epithelium and its transport processes during acute lung injury (ALI). Since relevant clinical outcomes correlate with rates of edema clearance in ALI, therapies based on our understanding of the mechanisms and regulation of fluid transport may be developed.
肺水肿液的清除是通过主动离子转运实现的，主要由肺泡上皮细胞完成。肺泡上皮细胞表面的各种离子泵和离子通道在整个上皮细胞间产生渗透梯度，进而促使水分从气腔中移出。在此，我们综述肺泡离子及液体清除的机制。此外，还讨论了许多调节水肿清除速率的因素，如儿茶酚胺、类固醇、细胞因子和生长因子。最后，我们阐述急性肺损伤（ALI）期间肺泡上皮细胞及其转运过程的变化。鉴于相关临床结果与ALI中的水肿清除速率相关，基于我们对液体转运机制和调节的理解，或许可以开发出相应的治疗方法。
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