Chi Yunfei, Liu Xiangyu, Chai Jiake
Burn Institute, The Fourth Medical Center of the PLA General Hospital, Beijing, China.
Ann Transl Med. 2021 Apr;9(8):719. doi: 10.21037/atm-21-1267.
We aimed to review and discuss some of the latest research results related to post-burn pathophysiological changes and provide some clues for future study.
Burns are one of the most common and serious traumas and consist of a series of pathophysiological changes of thermal injury. Accompanied by thermal damage to skin and soft tissues, inflammatory mediators are released in large quantities. Changes in histamine, bradykinin, and cytokines such as vascular endothelial growth factor (VEGF), metabolic factors such as adenosine triphosphate (ATP), and activated neutrophils all affect the body's vascular permeability.
We searched articles with subject words "microvascular permeability", "burn" "endothelium", and "endothelial barrier" in PubMed in English published from the beginning of database to Dec, 2020.
The essence of burn shock is the rapid and extensive fluid transfer in burn and non-burn tissue. After severe burns, the local and systemic vascular permeability increase, causing intravascular fluid extravasation, leading to a progressive decrease in effective circulation volume, an increase in systemic vascular resistance, a decrease in cardiac output, peripheral tissue edema, multiple organ failure, and even death. There are many cells, tissues, mediators and structures involved in the pathophysiological process of the damage to vascular permeability. Ulinastatin is a promising agent for this problem.
我们旨在回顾和讨论一些与烧伤后病理生理变化相关的最新研究成果，并为未来的研究提供一些线索。
烧伤是最常见且严重的创伤之一，由一系列热损伤的病理生理变化组成。伴随着皮肤和软组织的热损伤，炎症介质大量释放。组胺、缓激肽以及血管内皮生长因子（VEGF）等细胞因子、三磷酸腺苷（ATP）等代谢因子以及活化的中性粒细胞的变化均会影响机体的血管通透性。
我们在PubMed中检索了从数据库建立之初至2020年12月以英文发表的、主题词为“微血管通透性”“烧伤”“内皮”和“内皮屏障”的文章。
烧伤休克的本质是烧伤组织和未烧伤组织中迅速且广泛的液体转移。严重烧伤后，局部和全身血管通透性增加，导致血管内液体外渗，进而使有效循环血量逐渐减少、全身血管阻力增加、心输出量降低、外周组织水肿、多器官功能衰竭甚至死亡。血管通透性损伤的病理生理过程涉及许多细胞、组织、介质和结构。乌司他丁是解决这一问题的一种有前景的药物。
