1例COVID-19患者的发病综合征管理

E. Khodosh
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摘要

背景。在冠状病毒肺炎的情况下,病毒会破坏支气管和肺泡细胞,并引发强烈的炎症反应,破坏表面活性剂,阻止充分的氧合。这些发病环节导致急性呼吸窘迫综合征、多器官缺氧和弥散性血管内凝血综合征的发展。目标。了解冠状病毒病(COVID-19)治疗可能影响的主要致病环节。材料和方法。对这一主题的文献来源进行分析。结果和讨论。缺氧是新冠病毒器官损伤的主要背景之一。缺氧的后果包括有氧和无氧糖酵解失衡、脂质过氧化增加、酸中毒、微循环障碍、水肿。病理性活动性炎症是另一个背景。导致肺毛细血管损伤,微循环障碍,发展为缺氧加重的急性呼吸窘迫综合征。由于活性氧是细胞凋亡和线粒体功能障碍的主要诱导剂,因此有必要给予抗氧化治疗。依达拉奉(Ksavron,“Yuria-Pharm”)能迅速中和大量自由基,抑制脂质过氧化,激活自身抗氧化防御。COVID-19病理治疗的其他组成部分可能包括替沃汀和替沃雷尔(“Yuria-Pharm”)。l -精氨酸(Tivortin)是一氧化氮供体。它具有血管扩张、免疫刺激、膜稳定、细胞保护和抗氧化作用。替佛瑞尔还含有左旋肉碱,能抑制细胞凋亡,具有抗氧化和心脏保护作用。如果是肺炎,建议使用Reosorbilact(“Yuria-Pharm”),它可以防止肺水肿,恢复微循环。结论:1。缺氧和高炎症是新冠肺炎发病机制的主要因素。2. 依达拉奉(Ksavron)能中和自由基,激活自身抗氧化防御。3.l -精氨酸(Tivortin和Tivorel的一种成分)具有血管扩张、免疫刺激、膜稳定、细胞保护和抗氧化作用。4. 吸山梨醇可预防肺水肿,恢复微循环。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Pathogenetic syndrome management of a patient with COVID-19
Background. In case of coronavirus pneumonia, the virus damages the cells of bronchi and alveoli, as well as triggers a powerful inflammatory response that disrupts the surfactant and prevents the adequate oxygenation. These pathogenetic links lead to the development of acute respiratory distress syndrome, multiorgan hypoxia and disseminated intravascular coagulation syndrome. Objective. To find out the main pathogenetic links that can be affected by coronavirus disease (COVID-19) treatment. Materials and methods. Analysis of literature sources on this topic. Results and discussion. Hypoxia is one of the main backgrounds of coronavirus organ damage in COVID-19. The consequences of hypoxia include the imbalance between aerobic and anaerobic glycolysis, increased lipid peroxidation, acidosis, microcirculation disorders, edema. Pathologically active inflammation is another background. It leads to the damage of pulmonary capillaries, microcirculation disorders and the development of acute respiratory distress syndrome with increased hypoxia. Since the reactive oxygen species are the main inducers of apoptosis and mitochondrial dysfunction, it is necessary to prescribe antioxidant therapy. Edaravone (Ksavron, “Yuria-Pharm”) quickly neutralizes lots of free radicals, inhibits lipid peroxidation and activates the own antioxidant defense. Other components of the pathogenetic therapy of COVID-19 may include Tivortin and Tivorel (“Yuria-Pharm”). L-arginine (Tivortin) is a nitric oxide donor. Its administration has vasodilating, immunostimulating, membrane stabilizing, cytoprotective and antioxidant effects. Tivorel also contains L-carnitine, which inhibits apoptosis, has antioxidant and cardioprotective effects. In case of pneumonia, it is advisable to use Reosorbilact (“Yuria-Pharm”), which prevents pulmonary edema and restores microcirculation. Conclusions. 1. Hypoxia and hyperinflammation are the main elements of the COVID-19 pathogenesis. 2. Edaravone (Ksavron) neutralizes free radicals and activates own antioxidant defense. 3. L-arginine (a component of Tivortin and Tivorel) has vasodilating, immunostimulating, membrane stabilizing, cytoprotective and antioxidant effects. 4. Reosorbilact prevents pulmonary edema and restores microcirculation.
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