rmtОбщая реаниматологияGeneral Reanimatology1813-97792411-7110FSBI "SRIGR" RAMS10.15360/1813-9779-2005-5-13-16rmt-1216Research ArticleОСТРАЯ ДЫХАТЕЛЬНАЯ НЕДОСТАТОЧНОСТЬACUTE RESPIRATORY FAILUREЭтиология, патогенез и патологическая анатомия диффузного альвеолярного поврежденияThe Etiology, Pathogenesis, and Pathological Anatomy of Diffuse Alveolar LesionЧерняевА. Л.ChernyaevA. L.СамсоноваМ. В.SamsonovaM. V.ГУ НИИ пульмонологии МЗ и СР России, МоскваResearch Institute of Pulmonology, Ministry of Heath and Social Development of the Russian Federation, Moscow20052010200515Том I № 5 2005 г.1316Copyright © Черняев А.Л., Самсонова М.В., 20052005Черняев А.Л., Самсонова М.В.Chernyaev A.L., Samsonova M.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.reanimatology.com/rmt/article/view/1216

В настоящей статье рассматривается современная концепция диффузного альвеолярного повреждения (ДАП) — достаточно часто встречающегося состояния, требующего проведения интенсивных терапевтических мероприятий. Клиническим проявлением морфологии ДАП является респираторный дистресс-синдром взрослых. Приведены причины возникновения ДАП — на фоне инфекционного процесса, включая септические состояния; ингаляций токсичных газов и аэрозолей; при шоке; действии радиации; лекарственной терапии и др. Подробно описан патогенез развития ДАП и патологическая анатомия, при этом характеризуются патологические изменения в легких на разных сроках от начала развития заболевания.

The paper considers the current concept of diffuse alveolar lesion (DAL), a rather rare condition that requires intensive care measures. The clinicomorphological manifestation of DAL is adult respiratory distress syndrome. The causes of DAL occurring with an infectious process, including septic conditions, as well as with inhalations of toxic gases and aerosols; shock, radiation, drug therapy, etc. are presented. The pathogenesis of DAL and its pathological anatomy is described in detail, pathological lung alterations in different periods after the onset of the disease being characterized.

ReferencesKatzenstein A.-L.A., Bloor C., LibowA. Diffuse alveolar damage. The role of oxygen, shock, and related factors. Am. J. Pathol. 1976; 85: 210.Katzenstein A.-L.A., Bloor C., LibowA. Diffuse alveolar damage. The role of oxygen, shock, and related factors. Am. J. Pathol. 1976; 85: 210.Katzenstein A. Katzenstein and askin's surgical pathology of non-neoplastic lung disease. 3 rd. ed. Virginia: Livolsi; 1997. Vol. 13 of series Major problems in pathology. Toronto: W. B. Saunders company; Ch. 2. 14—47.Katzenstein A. Katzenstein and askin's surgical pathology of non-neoplastic lung disease. 3 rd. ed. Virginia: Livolsi; 1997. Vol. 13 of series Major problems in pathology. Toronto: W. B. Saunders company; Ch. 2. 14—47.Yardy A., Tomashefski I., Yagan R., Klienerman I. Regional alveolar damage (RAD). A localized counterpart of diffuse alveolar damage. Am. J. Clin. Pathol. 1989; 92: 10.Yardy A., Tomashefski I., Yagan R., Klienerman I. Regional alveolar damage (RAD). A localized counterpart of diffuse alveolar damage. Am. J. Clin. Pathol. 1989; 92: 10.Sloane P. I., Gee M. H., Gottlieb I. E. et al. A multicenter registry of patients with acute respiratory distress syndrome.Physiology and outcome. Am. Rev. Resp. Dis. 1992; 146: 419.Sloane P. I., Gee M. H., Gottlieb I. E. et al. A multicenter registry of patients with acute respiratory distress syndrome.Physiology and outcome. Am. Rev. Resp. Dis. 1992; 146: 419.Katzenstein A. L-A. Pathogenesis of «fibrosis» in interstitial pneumonia. An electron microscopic study. Hum. Pathol. 1985; 16: 1015.Katzenstein A. L-A. Pathogenesis of «fibrosis» in interstitial pneumonia. An electron microscopic study. Hum. Pathol. 1985; 16: 1015.Fukuda Y., Ishizaki M., Masuda Y. et al. The role of interalveolar fibrosis in the process of pulmonary structural remodeling in patients with diffuse alveolar damage. Am. J. Pathol. 1987;126: 171Fukuda Y., Ishizaki M., Masuda Y. et al. The role of interalveolar fibrosis in the process of pulmonary structural remodeling in patients with diffuse alveolar damage. Am. J. Pathol. 1987;126: 171Kuhn C. Patterns of lung repair; a morphologist's view chest 99 (suppl) 1991: 11s.Kuhn C. Patterns of lung repair; a morphologist's view chest 99 (suppl) 1991: 11s.Kooy N. W., Royall I. A., Ye Y. Z., et al. Evidence for in vivo peroxynitrite production in human acute lung injury. Am. J. Resp. Crit. Care Med. 1995; 151: 1250.Kooy N. W., Royall I. A., Ye Y. Z., et al. Evidence for in vivo peroxynitrite production in human acute lung injury. Am. J. Resp. Crit. Care Med. 1995; 151: 1250.Repine Y. E. Scientific perspectives on adult respiratory distress syndrome. Lancet 1992; 339: 466.Repine Y. E. Scientific perspectives on adult respiratory distress syndrome. Lancet 1992; 339: 466.Henke C., Marineili W., Jessurun I. et al. Macrophage production of basic fibroblast growth factor in the fibroproliferative disorder of alveolar fibrosis after lung injury. Am. J. Pathol. 1993; 143: 1189.Henke C., Marineili W., Jessurun I. et al. Macrophage production of basic fibroblast growth factor in the fibroproliferative disorder of alveolar fibrosis after lung injury. Am. J. Pathol. 1993; 143: 1189.Nash G., Blennerhassett Y., Pontoppidan H. Pulmonary lesions associated with oxygen therapy and artificial ventilation. N. Engl. J. Med. 1967; 276: 368.Nash G., Blennerhassett Y., Pontoppidan H. Pulmonary lesions associated with oxygen therapy and artificial ventilation. N. Engl. J. Med. 1967; 276: 368.Takahashi T., Takahashi Y., Nio M. Remodeling of the alveolar structure in the paraguat lung of humans: a morphometric study. Hum. Pathol.1994; 25: 702.Takahashi T., Takahashi Y., Nio M. Remodeling of the alveolar structure in the paraguat lung of humans: a morphometric study. Hum. Pathol.1994; 25: 702.Snow R., Davies P., Pontoppidan H. et al. Pulmonary vascular remodeling in adult respiratory distress syndrome. Am. Rev. Resp. Dis. 1982; 126: 887.Snow R., Davies P., Pontoppidan H. et al. Pulmonary vascular remodeling in adult respiratory distress syndrome. Am. Rev. Resp. Dis. 1982; 126: 887.Homma S., Jones R., Gvist I. et al. Pulmonary vascular lesions in the adult, respiratory distress syndrome caused by inhalation of zinc chloride smoke: a morphometric study. Hum. Pathol. 1992; 23: 45Homma S., Jones R., Gvist I. et al. Pulmonary vascular lesions in the adult, respiratory distress syndrome caused by inhalation of zinc chloride smoke: a morphometric study. Hum. Pathol. 1992; 23: 45Nash J. R. G., McLaughlin P. J., Hoyle C., Roberts D. Immunolocalization of tumor necrosis factor in lung tissue from patients dying with adult respiratory distress syndrome. Hystopathology 1991; 19: 395.Nash J. R. G., McLaughlin P. J., Hoyle C., Roberts D. Immunolocalization of tumor necrosis factor in lung tissue from patients dying with adult respiratory distress syndrome. Hystopathology 1991; 19: 395.Kogan E. A., Dengin V. V., Jagues G. et al. Idiopathic fibrosing alveolitis (IFA) as a background for the lung cancer development. Eur. Resp. J. 2002; 20: (Suppl 38); 479: 3019.Kogan E. A., Dengin V. V., Jagues G. et al. Idiopathic fibrosing alveolitis (IFA) as a background for the lung cancer development. Eur. Resp. J. 2002; 20: (Suppl 38); 479: 3019.Greene R. Adult respiratory distress syndrome: acute alveolar damage. Radiology 1987; 163: 57Greene R. Adult respiratory distress syndrome: acute alveolar damage. Radiology 1987; 163: 57Suchyta M. R., Clemmer T. P., Elliott C. G. et al. The adult respiratory distress syndrome; a report of survival and modifying factors. Chest 1992; 101: 1074.Suchyta M. R., Clemmer T. P., Elliott C. G. et al. The adult respiratory distress syndrome; a report of survival and modifying factors. Chest 1992; 101: 1074.

The authors declare that there are no conflicts of interest present.