Christmann U, Buechner-Maxwell V A, Witonsky S G, Hite R D
Department of Large Animal Clinical Sciences, Virginia-Maryland Regional College of Veterinary Medicine, Duck Pond Drive, Phase II, Blacksburg, VA 24061, USA.
J Vet Intern Med. 2009 Mar-Apr;23(2):227-42. doi: 10.1111/j.1939-1676.2008.0269.x. Epub 2009 Feb 3.
Lung surfactant is produced by type II alveolar cells as a mixture of phospholipids, surfactant proteins, and neutral lipids. Surfactant lowers alveolar surface tension and is crucial for the prevention of alveolar collapse. In addition, surfactant contributes to smaller airway patency and improves mucociliary clearance. Surfactant-specific proteins are part of the innate immune defense mechanisms of the lung. Lung surfactant alterations have been described in a number of respiratory diseases. Surfactant deficiency (quantitative deficit of surfactant) in premature animals causes neonatal respiratory distress syndrome. Surfactant dysfunction (qualitative changes in surfactant) has been implicated in the pathophysiology of acute respiratory distress syndrome and asthma. Analysis of surfactant from amniotic fluid allows assessment of fetal lung maturity (FLM) in the human fetus and exogenous surfactant replacement therapy is part of the standard care in premature human infants. In contrast to human medicine, use and success of FLM testing or surfactant replacement therapy remain limited in veterinary medicine. Lung surfactant has been studied in large animal models of human disease. However, only a few reports exist on lung surfactant alterations in naturally occurring respiratory disease in large animals. This article gives a general review on the role of lung surfactant in respiratory disease followed by an overview of our current knowledge on surfactant in large animal veterinary medicine.
肺表面活性物质由II型肺泡细胞产生，是磷脂、表面活性蛋白和中性脂质的混合物。表面活性物质可降低肺泡表面张力，对预防肺泡塌陷至关重要。此外，表面活性物质有助于保持较小气道通畅，并改善黏液纤毛清除功能。表面活性物质特异性蛋白是肺部固有免疫防御机制的一部分。在许多呼吸系统疾病中都有肺表面活性物质改变的描述。早产动物的表面活性物质缺乏（表面活性物质的定量不足）会导致新生儿呼吸窘迫综合征。表面活性物质功能障碍（表面活性物质的定性改变）与急性呼吸窘迫综合征和哮喘的病理生理学有关。分析羊水表面活性物质可评估人类胎儿的肺成熟度（FLM），外源性表面活性物质替代疗法是早产人类婴儿标准护理的一部分。与人类医学不同，FLM检测或表面活性物质替代疗法在兽医学中的应用和成功率仍然有限。已经在人类疾病的大型动物模型中对肺表面活性物质进行了研究。然而，关于大型动物自然发生的呼吸系统疾病中肺表面活性物质改变的报道很少。本文对肺表面活性物质在呼吸系统疾病中的作用进行了综述，随后概述了我们目前对大型动物兽医学中表面活性物质的认识。
