长期COVID中的气体交换异常是由血管成分的改变驱动的
Gianluca Imeri1, Caterina Conti1, Anna Caroli2
1ASST Papa Giovanni XXIII , Bergamo, BG, Italy.
Multidisciplinary respiratory medicine
|April 5, 2024
概括
幸存者的COVID-19后肺扩散障碍主要是由于血管问题,而不是气泡膜变化. 这项研究澄清了严重COVID-19后持续的呼吸道症状的原因.
科学领域:
- 肺部医学 肺部医学
- 呼吸系统生理学 呼吸系统生理学
- 传染性疾病 传染性疾病
背景情况:
- 关于COVID-19后肺扩散能力受损是否源于膜 (Dm) 变化,毛细管体积 (Vc) 变化,还是两者兼而有之,存在不确定性.
- 对氧化 (DLNO) 和一氧化碳 (DLCO) 的扩散能力的联合测量允许同时确定Vc和Dm,因为NO对血红蛋白的亲和力更高.
研究的目的:
- 精确识别感染后一年重度COVID-19幸存者的肺部扩散受损的原因.
- 要区分血管和膜成分,这些成分有助于COVID-19后气体交换异常.
主要方法:
- 利用结合的NO和CO气体转移技术 (DLNO和DLCO) 来评估肺气体交换.
- 评估了33名严重的COVID-19幸存者 (平均年龄67岁,70%男性) 感染后一年持久的症状或放射性发现.
- 进行了临床,肺功能和成像评估.
主要成果:
- 气体交换异常主要与血管损害有关,通过血管模式 (DLNO/DLCO ≥110%在76%的受试者中) 和降低Vc (73%的受试者中) 表示.
- 膜 (Dm) 损伤仅在9%的队列中观察到.
- 气体交换障碍与轻度胸部CT变化的程度之间没有发现显著的相关性 (大脑膜干涉平均为11%).
结论:
- 在患有COVID-19症状的幸存者中,在一年内CT检测结果最小,气体交换异常主要是由血管成分损伤驱动的.
- 气泡膜的扩散成分不太频繁地涉及COVID-19后一年的呼吸系统后遗症.
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