首页> 中文期刊> 《医学综述》 >连续性血液净化对重症急性胰腺炎细胞屏障功能的影响

连续性血液净化对重症急性胰腺炎细胞屏障功能的影响

         

摘要

The state of patients with severe acute pancreatitis( SAP) is dangerous and has many compli-cations.The damage of cell barrier plays an important role in the progress of SAP ,inclduing vascular endothe-lial barrier,intestinal mucosal barrier,pulmonary microvascular barrier and blood brain barrier.Destruction of the barrier function of endothelial cells,which results in increased capillary permeability and microvascular dis-turbance,eventually leads to plasma extravasation and hypovolemia.The destruction of intestinal barrier leads to bacterial translocation,and further activates and expands the inflammatory response.Alveolar-capillary barrier damage,results in ventilation dysfunction,and eventally refractory hypoxemia and respiratory failure.At pres-ent,continuous blood purification is widely used in the treatment of SAP ,because of its effective removal of inflammatory mediators and improvement of oxidative stress.%重症急性胰腺炎病情凶险、并发症多,细胞屏障功能的损害在其病理生理过程中发挥重要作用,包括血管内皮屏障、肠道黏膜上皮细胞屏障、肺微血管屏障及血脑屏障的损伤。当血管内皮细胞屏障功能受损时,毛细血管通透性增高及微循环障碍,导致血浆渗漏及有效血容量不足。而肠道黏膜屏障的损害会引发细菌移位,进一步激活并扩大炎症反应。肺微血管屏障的损害则导致换气功能障碍,最终导致顽固性低氧血症及呼吸衰竭。连续性血液净化能有效清除炎性介质及改善氧应激,目前被广泛用于重症急性胰腺炎的治疗。

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