Sarmiento Xavier, Guardiola Juan J, Soler Manuel
Servicio de Medicina Intensiva, Hospital Germans Trias i Pujol, Badalona, Barcelona, España.
Med Clin (Barc). 2013 Jun 18;140(12):546-53. doi: 10.1016/j.medcli.2012.09.011. Epub 2012 Nov 21.
Alcohol has been considered an important risk factor for the development of pneumonia since the last century. Nevertheless, it was not thought that it had relevant effects on lung structure and functions until recently. Recent studies have shown that the risk for acute respiratory distress syndrome (ARDS) is 2-4 times higher among alcoholic patients with sepsis or trauma, and that alcoholism can play a roll in more than 50% of cases in the pathogenesis of this syndrome. Although alcoholism per se does not cause acute lung injury it predisposes to pulmonary dysfunction after inflammatory stress, that is present in clinical situations that cause ARDS leading to its development and complicating its outcome. Recent investigations in animals and humans with alcohol abuse have uncovered several alterations currently known as the "alcoholic lung". This revision discusses the association between alcohol abuse and lung injury/ARDS and tries to explain the physiopathology along with possible treatments.
自上个世纪以来,酒精一直被视为肺炎发生的重要风险因素。然而,直到最近人们才认为它对肺结构和功能有相关影响。最近的研究表明,患有败血症或创伤的酗酒患者发生急性呼吸窘迫综合征(ARDS)的风险要高出2至4倍,而且在该综合征发病机制中,超过50%的病例与酗酒有关。虽然酗酒本身不会导致急性肺损伤,但它会使炎症应激后出现肺功能障碍,而炎症应激在导致ARDS发生并使其病情复杂化的临床情况中是存在的。最近对酗酒的动物和人类进行的研究发现了几种目前被称为“酒精性肺”的改变。本综述讨论了酗酒与肺损伤/ARDS之间的关联,并试图解释其病理生理学以及可能的治疗方法。