Droma Y, Hayano T, Takabayashi Y, Koizumi T, Kubo K, Kobayashi T, Sekiguchi M
First Department of Internal Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Eur Respir J. 1996 Sep;9(9):1947-9. doi: 10.1183/09031936.96.09091947.
We present a case of high altitude pulmonary oedema (HAPE) with pulmonary hypertension and polymorphonuclear leucocyte (PMN) accumulation in bronchoalveolar lavage fluid (BALF), which occurred in a 21 year old man. Plasma endothelin-1 (ET-1) and interleukin-8 (IL-8) concentration in BALF were elevated on admission, and returned to normal level at recovery, when the pulmonary artery pressure and the PMN counts in BALF were normal. In addition, E-selectin and intercellular adhesion molecule-1 (ICAM-1) in BALF were also slightly increased on admission. These findings suggest that endothelin-1 is a vasoconstrictor which contributes to the pulmonary hypertension in high altitude pulmonary oedema, and that some of the inflammatory mediators play an important role in chemotaxis and accumulation of polymorphonuclear leucocytes in the development of high altitude pulmonary oedema.
我们报告一例发生在一名21岁男性身上的伴有肺动脉高压和支气管肺泡灌洗（BALF）液中多形核白细胞（PMN）积聚的高原肺水肿（HAPE）病例。入院时BALF中的血浆内皮素-1（ET-1）和白细胞介素-8（IL-8）浓度升高，恢复时当肺动脉压和BALF中的PMN计数正常时，它们恢复到正常水平。此外，入院时BALF中的E-选择素和细胞间黏附分子-1（ICAM-1）也略有增加。这些发现表明内皮素-1是一种血管收缩剂，它导致高原肺水肿中的肺动脉高压，并且一些炎症介质在高原肺水肿发展过程中多形核白细胞的趋化和积聚中起重要作用。
