肺移植后微吸和胃肠功能障碍的管理:一个叙述性回顾
René Hage1,2, Carolin Steinack1,2, Macé M Schuurmans1,2
1Division of Pulmonology, University Hospital Zurich, 8091 Zurich, Switzerland.
JHLT open
|September 2, 2025
概括
微吸,通常是由于胃肠道问题, 显著驱动肺部移植功能障碍 (CLAD). 使用生物标志物及时诊断和及时干预,包括手术,可以改善移植结果.
科学领域:
- 肺部医学
- 移植免疫学
- 胃肠病学
背景情况:
- 慢性肺移植异能 (CLAD) 是肺移植后晚期死亡的主要原因.
- 微吸与胃肠功能障碍和GERD有关,是CLAD的关键非免疫因素.
- 沉默的表现和诊断挑战阻碍了微观吸收的有效管理.
研究的目的:
- 审查肺移植患者的病理生理学,诊断和微吸和肠道功能障碍的影响.
- 突出新兴的生物标志物和诊断工具.
- 讨论目前和新的治疗策略.
主要方法:
- 对最近的文献进行叙述的回顾.
- 专注于病理生理学,诊断方式和治疗策略.
- 结合胆汁酸和素A4等生物标志物的综合证据.
主要成果:
- 微吸收会导致上皮损伤,免疫激活和失能,导致异位移植功能障碍.
- 结合胆酸和素A4作为吸收生物标志物具有很高的特异性.
- 抗反流手术改善了移植结果, 保守措施提供了补充的好处.
结论:
- 微吸气是一种未被认可的,可改变的肺部移植损伤的原因.
- 综合生物标志物,早期反流评估和包括手术在内的逐步治疗可以提高长期移植的成功率.
- 这一审查为诊断和管理与微吸相关的损伤提供了一个框架.
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