国际麻醉学与复苏杂志   2012, Issue (12): 5-5
    
机械通气相关性肺损伤中α7烟碱型乙酰胆碱受体的作用和机制
敖丽, 闵苏1()
1.重庆医科大学附属第一医院
The role and mechanism of α7-nicotinic acetylcholine receptors in ventilation-induced lung injury
 全文:
摘要:

背景 机械通气是治疗急性肺损伤(acute lung injury, ALI)和急性呼吸窘迫综合征(acute respiratory distress syndrome, ARDS)的必要措施,但同时又增加了机械通气相关性肺损伤(ventilation-induced lung injury,VILI)的发病率。而胆碱能抗炎通路是近年来发现的一种通过传出迷走神经来抑制炎症的神经-内分泌抗炎途径,其主要通过α7烟碱型乙酰胆碱受体(α7 nicotinic acetylcholine receptors type, α7nAChR)发挥作用。目的 对α7nAChR在VILI中的作用和机制的研究进展进行回顾和总结。内容 共4部分:① VILI研究现状与共识。② 胆碱能抗炎通路的研究进展。③ α7nAChR在VILI中的具体机制。④ 归纳总结。趋向 α7nAChR在VILI中的作用和机制错综复杂,弄清这些复杂的信号转导机制对于揭示VILI的发生机制和预防VILI的发生具有临床意义。

关键词: 机械通气相关肺损伤;胆碱能抗炎通路;a7烟碱型乙酰胆碱受体
Abstract:

Background Mechanical ventilation is a necessaryand useful treatment of acute lung injury (ALI) And acute respiratory distress syndrome(ARDS). But at the same time mechanical ventilation will induce lung injury(ventilation induced lung injury, VILI). And cholinergic Anti-inflammatory Pathway is found in recent years. It is a kind of spread through the vagus nerve to curb inflammation of nerve-endocrine anti-inflammatory way. And play a crucial role by α7 nicotinic acetylcholine receptors type (α7 nAChR). Objective This review highlights the advance in mechanism of α7 nAChR in VILI,summarizing current best evidenceing on its clinical application. Content Our review will be divided into four parts: The state of the art and consensus in VILI. Study progress of cholinergic anti-inflammatory pathway. The role and mechanism of α7 nAChR in VILI. Sum up. Trend The cardioprotective mechanisms of α7 nAChR in VILI are complicated.Fully understand these complex mechanisms of signal transduction will be helpful to illuminate the principle and promote its clinical application.

Key words: Ventilation-induced lung injury; Cholinergic anti-inflammatory pathway; α7 -nicotinic acetylcholine receptors