Current Location:home > Detailed Browse

Article Detail

2019年新型冠状病毒导致的致命肺渗漏的病理生理学机制和防治策略

Pathophysiology-based mechanism and management strategies for deadly leaking lungs caused by 2019 novel coronavirus

Abstracts

自2019年12月爆发以来,2019年新型冠状病毒已在全球造成2596人死亡,并且有超过11,000名患者仍处于严重状况。该病毒和由该病毒引起的医疗状况被命名为SARS-CoV-2和COVID-19。虽然已经广泛应用了抗病毒、对症和功能支持性疗法,每天仍有100多名患者死于该病毒感染。COVID-19最常见的致命并发症是急性呼吸窘迫综合征(ARDS)。SARS-CoV-2在世界范围内的大流行可能仍然存在。其它病毒感染引起的肺炎亦可导致ARDS,出现类似的危重情形,这些病毒包括如非典型的急性呼吸系统综合症(SARS)、中东呼吸综合征(MERS)和流感病毒引起的肺炎。因此,制定更有效的降低病毒所致的ARDS死亡率的策略,不但是当前抗新冠疫情的迫切需要,也是全球范围内降低病毒性肺炎死亡率的长期需要。ARDS曾被称为湿肺,血管泄漏导致的肺水肿是其最重要的病理特征之一,重型COVID-19的临床表现和胸部计算机断层扫描图像特征(白肺)符合ARDS。确定水肿液从何处及如何渗漏到肺部,是制定基于机制的预防和阻止水从肺毛细管向肺间质渗漏的策略,降低湿肺死亡率的关键。对于轻度和中度病例,非类固醇消炎药,如用于风湿性关节炎的药物,可能有助于防止和减少这种漏水。免疫抑制剂(如西罗莫司和巨蜥)可能使病毒感染、免疫反应和非免疫炎症造成的损伤高峰时间错开,从而降低肺漏水程度,防止危及生命情况出现。使用清火中草药可能也有抗炎用。对于严重病例,血液透析可能是消除大多数炎症介质和细胞毒性物质的有效策略。
[英文摘要]The 2019 novel coronavirus has killed 2596 globally since the outbreak began in December 2019 and more than 11,000 patients are still in severe conditions. The virus and medical conditions caused by the virus were named as SARS-CoV-2 and COVID-19. Although antiviral, symptomatic, and functionally supportive treatments have been applied, more than 100 patients die each day from infection with the virus. The most common deadly complication of COVID-19 is acute respiratory distress syndrome (ARDS). SARS-CoV-2 infection may become pandemic. ARDS is caused by various similar viruses, such as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), and influenza viruses. Thus, strategies for decreasing the mortality of virus-initiated ARDS are needed at the urgent, long-term, and broad levels. ARDS was previously referred to as wet lungs with vascular leaking, which described the clinical manifestations and chest computed tomography images of COVID-19-ARDS. Determining from where and how water is leaking into the lungs will lead to the development of mechanism-based management strategies for reducing mortality. These approaches can be used to prevent and stop water leakage from the pulmonary capillary into the lung interstitial space. For mild and moderate cases, nonsteroidal anti-inflammatory drugs, such as those used for rheumatoid arthritis, may be useful for preventing and deceasing this water leakage. Administration of immunosuppressants, such as sirolimus and tacrolimus, may stagger the peak times of injuries caused by viral infection, immune response, and non-immune inflammation to decrease the extent of water leakage and prevent life-threatening conditions. Using anti-flame (Qing-Huo) Chinese herbs may also be useful. For severe case, blood dialysis can be an effective strategy for eliminating most inflammatory mediators and cytotoxic substances.
Download Comment Hits:21140 Downloads:2639
From: Sifeng Chen
DOI:10.12074/202002.00075
Recommended references: Chen, Sifeng.(2020).2019年新型冠状病毒导致的致命肺渗漏的病理生理学机制和防治策略.[ChinaXiv:202002.00075] (Click&Copy)
Version History
[V1] 2020-02-25 01:13:59 chinaXiv:202002.00075V1 Download
Related Paper

Download

Current Browse

Change Subject Browse

Cross Subject Browse