高地での肺腫は,最初は毛細血管の圧力の上昇によって引き起こされます
M Maggiorini1, C Mélot, S Pierre
1Department of Internal Medicine, UniversitätsSpital, Zürich, Switzerland. klinmax@usz.unizh.ch
Circulation
|April 25, 2001
まとめ
高地肺腫 (HAPE) は,主に肺毛細血管の圧力の上昇によって引き起こされ,毛細血管の透過性の増加によって引き起こされません. この発見は,HAPEの高度での発達を理解するのに役立ちます.
科学分野:
- 生理学 生理学とは
- 高度医学は,高度医学である.
- 心血管研究 循環器科の研究
背景:
- 高地肺腫 (HAPE) は,重度の肺高血圧と炎症を伴う.
- HAPEの初期誘発因子,つまり圧力の上昇や透過性の上昇は不明である.
研究 の 目的:
- HAPEの発達における肺毛細血管の圧力と透過性の役割を調査する.
- HAPE感受性の高い個体における血液動力学的反応を,異なる高度での対照群と比較するために.
主な方法:
- 毛細血管圧力を含む肺の血液動力学測定 (オクラージョン法).
- 67Ga-ラベル付トランスリン脱出を用いて毛細血管の透過性を評価した.
- 16人のHAPE感受性被験者と,低 (490m) と高 (4559m) の14人の対照群を比較した.
主要な成果:
- HAPE感受性の被験者は,低酸素への肺血管活性が強化されたことを示しました.
- 高 altitude で,感受性の高い被験者は,より高い肺動脈 (37 vs 26 mmHg) と毛細血管圧 (19 vs 13 mmHg) を示した.
- HAPEの発達は,肺毛細血管の圧力>19 mmHgと相関しており,透過性は有意に異なるものではありませんでした.
結論:
- 高地肺腫は,肺毛細血管の圧力が上昇したときに発症します.
- 肺毛細血管の圧力は,HAPEの病原性における重要な要因である.
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