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轻型 SARS-CoV-2 间质性肺炎的病理生理学：从组织病理学特征到临床表现。

Pathophysiology of light phenotype SARS-CoV-2 interstitial pneumonia: from histopathological features to clinical presentations.

机构信息

Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy.

Department of Diseases of the Thorax, GB Morgagni Hospital, Forlì, FC, Italy.

出版信息

Pulmonology. 2022 Sep-Oct;28(5):333-344. doi: 10.1016/j.pulmoe.2021.03.003. Epub 2021 Mar 26.

DOI:10.1016/j.pulmoe.2021.03.003
PMID:33832850
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7997696/
Abstract

Little is known about the light phenotype of SARS-CoV-2 pneumonia, which behaves in an unusual way, unlike other known respiratory diseases. We believe that the histopathological features of early COVID-19 could be considered the pathophysiological hallmark of this disease. Lung cryobiopsies show almost pristine alveoli, enlarged/hyperplasic alveolar capillaries along with dilatation of the post capillary pulmonary venules. Hypoxemia could therefore be explained by a reduction of the normal V/Q ratio, due to blood overflow around well ventilated alveoli. This could clarify typical manifestations of type L COVID-19, such as happy hypoxemia, response to awake prone positioning, response to PEEP/CPAP and platypnea orthodeoxia.

摘要

关于 SARS-CoV-2 肺炎的光表型知之甚少，其表现方式与其他已知的呼吸道疾病不同。我们认为，COVID-19 的早期组织病理学特征可以被认为是这种疾病的病理生理学标志。肺冷冻活检显示几乎是原始的肺泡，增大/增生的肺泡毛细血管以及毛细血管后肺小静脉扩张。因此，低氧血症可以通过正常 V/Q 比值的降低来解释，这是由于富含氧气的肺泡周围血液溢出导致的。这可以解释 COVID-19 型 L 的典型表现，如快乐性低氧血症、对清醒俯卧位的反应、对 PEEP/CPAP 的反应以及平板呼吸-低氧血症。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/b47fd7e21f7c/gr9_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/687e0ad067e8/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/ff46558f6f61/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/07e958511d33/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/63b61d3a6143/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/ca8b811b77c2/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/a8500f7c8709/gr6_lrg.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/b47fd7e21f7c/gr9_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/687e0ad067e8/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/ff46558f6f61/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/07e958511d33/gr3_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/63b61d3a6143/gr4_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/ca8b811b77c2/gr5_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/a8500f7c8709/gr6_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/a48e03943901/gr7_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/27c52046eaf0/gr8_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6af9/7997696/b47fd7e21f7c/gr9_lrg.jpg

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