摘要
慢性血栓栓塞性肺动脉高压(CTEPH)属于第四类肺动脉高压。肺动脉栓子阻塞血管导致肺动脉压力升高及肺微小血管重构, 远期可引发右心室重塑及右心衰竭, 甚至死亡。右心室功能状态是影响CTEPH患者预后的重要指标, 然而CTEPH肺微血管重塑、右心结构和功能适应及失代偿等发生机制尚不完全清楚。较其他分类肺动脉高压, CTEPH肺微血管重构的信号通路与远期肺动脉压力的进展变化存在差异。建立稳定具有人类CTEPH的关键临床特征和随后右心室重构的动物模型可能为解决该问题提供重要依据。本文就已有猪、犬和羊等大型动物模型及病理生理研究进行综述, 旨在提高对CTEPH病理生理的认识, 并为深入开展CTEPH研究奠定基础。
Chronic thromboembolic pulmonary hypertension(CTEPH)falls within the fourth category of pulmonary hypertension(PH).Pulmonary vascular obstruction with thrombus causes elevated pulmonary arterial pressure and pulmonary microvascular remodeling,further leading to pulmonary microvascular remodeling and even right heart failure or death.The status of right ventricular(RV)function is the most important indicator effecting the prognosis of CTEPH patients.However,the pathogenesis involved in pulmonary microvascular remodeling,RV structural and functional adaptation,decompensation,etc remains being unclear.Meanwhile,the signaling pathway of pulmonary microvascular remodeling in CTEPH is found to be different from the progression and alternation of long-term pulmonary arterial pressure compared with other forms of PH.It is likely to provide significant foundation for solving the issue by establishing stable animal models mimicking human CTEPH and subsequent RV remodeling.The existing large animal models including pigs,canines and sheep,as well as pathophysiological studies are reviewed in this Paper,for purposes of strengthening the understanding on physiopathologic conditions of CTEPH and laying the foundation for in-depth research on CTEPH.
作者
许文清
刘敏
Xu Wenqing;Liu Min(Peking University China-Japan Friendship School of Clinical Medicine,Beijing 100191,China;Department of Radiology,China-Japan Friendship Hospital,Beijing 100029,China)
出处
《国际呼吸杂志》
2023年第5期615-620,共6页
International Journal of Respiration
基金
国家自然科学基金(81871328)
中日友好医院高水平医院临床业务费专项临床研究项目(2022-NHLHCRF-LX-01)
中日友好医院"菁英计划"人才培育工程(ZRJY2021-BJ02)
中国医学科学院医学与健康科技创新工程"揭榜挂帅"项目(2021-I2M-1-049)。
关键词
肺动脉高压
血栓栓塞
模型
动物
肺血管重构
右心室重构
心律失常
Pulmonary hypertension
Thromboembolism
Models,animal
Pulmonary vascular remodeling
Pulmonary vascular remodeling
Right ventricular remodeling
Arrhythmia
