症状后的COVID患者有膜毛细管膜功能受损,VE/VCO2高
Piergiuseppe Agostoni1,2, Massimo Mapelli3,4, Elisabetta Salvioni3
1Centro Cardiologico Monzino, IRCCS, Milan, Italy. piergiuseppe.agostoni@unimi.it.
后COVID-19心肺呼吸系统症状与运动测试结果和膜细胞功能障碍有关. 毛细血管体积的减少表明肺血管损伤,影响呼吸障碍和疲劳等症状.
科学领域:
- 肺部医学 肺部医学
- 心血管呼吸系统生理学
- 传染病研究 传染病研究
背景情况:
- 后COVID-19综合征经常出现心肺呼吸系统症状.
- 这些持续性症状的根本原因仍然不完全理解.
研究的目的:
- 研究COVID-19后综合征的心肺呼吸机制和生理基础.
- 为了确定与COVID-19后患者报告的症状相关的客观标记.
主要方法:
- 评估了204名COVID-19后的患者,进行了全面的临床评估,包括螺旋计 (测量一氧化碳/氧化的扩散能力,DLCO/DLNO),心肺运动测试 (CPET) 和胸部CT.
- 评估表面活性剂衍生蛋白B (SP-B) 作为膜细胞功能的标志物.
主要成果:
- 呼吸不全,疲劳和疲劳等心肺呼吸系统症状普遍存在.
- 在CPET上提高VE/VCO2斜率与呼吸障碍,疲劳和疲劳性有显著的相关性.
- 观察到毛细血管体积 (Vcap) 减少,表明肺血管损伤,并且与SP-B水平负相关.
结论:
- 在COVID-19后的心肺呼吸系统症状与气体交换效率受损有关,由VE/VCO2斜率表示.
- 气膜细胞失调,由升高的SP-B证明,以及肺血管损伤 (低Vcap) 导致病理生理学.
- 虽然扩散能力 (DLCO) 受到最小的影响,但膜-毛囊膜扩散 (DM) 得到保留,这表明了特定的损伤模式.
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