West J B, Mathieu-Costello O
Department of Medicine, University of California San Diego (La Jolla) 92093-0623, USA.
Circulation. 1995 Aug 1;92(3):622-31. doi: 10.1161/01.cir.92.3.622.
The pulmonary blood-gas barrier presents a dilemma. It must be extremely thin for efficient gas exchange. However, it also needs to be immensely strong because the stresses in the pulmonary capillary wall become extremely high when the capillary pressure rises. Stress failure of the capillaries occurs in several pathological conditions. It causes high-permeability edema as in neurogenic pulmonary edema or high-altitude pulmonary edema; alveolar hemorrhage, which occurs in all galloping racehorses; or a combination of the two as in severe congestive heart failure. The vulnerability of the capillary wall to increased mechanical stress has not previously been sufficiently appreciated.
肺气血屏障存在一个难题。为实现高效气体交换，它必须极其薄。然而，它也需要无比坚固，因为当毛细血管压力升高时，肺毛细血管壁上的应力会变得极高。毛细血管的应力衰竭在几种病理状况下会发生。它会导致高通透性水肿，如神经源性肺水肿或高原肺水肿；肺泡出血，这在所有奔跑的赛马中都会出现；或者两者兼而有之，如在严重充血性心力衰竭中。毛细血管壁对机械应力增加的脆弱性此前尚未得到充分认识。
