Những hướng đi mới trong điều trị bệnh tim mạch đi kèm ở bệnh phổi tắc nghẽn mãn tính

Clinical Science - Tập 133 Số 7 - Trang 885-904 - 2019
Kurt Brassington1, Stavros Selemidis1, Steven Bozinovski1, Ross Vlahos1
1School of Health and Biomedical Sciences, RMIT University, Bundoora, VIC, 3083, Australia

Tóm tắt

Tóm tắt

Bệnh phổi tắc nghẽn mãn tính (COPD) là một căn bệnh được đặc trưng bởi sự hạn chế lưu lượng không khí kéo dài không thể đảo ngược hoàn toàn và hiện là nguyên nhân gây tử vong hàng thứ tư trên toàn cầu. Hiện nay, đã được xác nhận rằng các bệnh lý tim mạch liên quan góp phần gây ra bệnh tật và tử vong ở bệnh nhân COPD, với khoảng 50% số ca tử vong ở bệnh nhân COPD được cho là do các biến cố tim mạch (ví dụ: nhồi máu cơ tim). Bệnh tim mạch (CVD) và COPD chia sẻ nhiều yếu tố nguy cơ khác nhau bao gồm tăng huyết áp, ít vận động, hút thuốc và chế độ ăn uống kém, nhưng các cơ chế cơ bản vẫn chưa được thiết lập hoàn toàn. Tuy nhiên, có những bằng chứng thí nghiệm và lâm sàng ngày càng rõ ràng cho thấy căng thẳng oxy hóa gây ra viêm phổi và sự tràn ngập của các chất trung gian pro-inflammatory từ phổi vào tuần hoàn hệ thống dẫn đến một phản ứng viêm hệ thống kéo dài, làm thay đổi cấu trúc mạch máu, thông qua việc tái tạo mạch máu và độ cứng động mạch, dẫn đến xơ vữa động mạch. Ngoài ra, sự điều chỉnh các chất hoạt tính vaso từ nội mô (ví dụ: nitric oxide (NO)), kiểm soát trương lực mạch máu cũng bị thay đổi bởi tổn thương oxy hóa của các tế bào nội mô mạch, do đó thúc đẩy rối loạn chức năng mạch máu, một yếu tố chính thúc đẩy CVD. Trong bài tổng quan này, vai trò có hại của căng thẳng oxy hóa trong COPD và CVD đi kèm được thảo luận và chúng tôi đề xuất rằng việc nhắm đến các cơ chế phụ thuộc vào oxy hóa là một chiến lược mới trong điều trị CVD liên quan đến COPD.

Từ khóa

#COPD #bệnh tim mạch #căng thẳng oxy hóa #viêm phổi #điều trị CVD

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