静脉移植体病变的病理过程及其影响机制

冠状动脉旁路移植术广泛用于临床治疗冠心病,自体静脉是移植血管的主要来源,但移植术后再狭窄大大降低了手术成功率.临床跟踪研究发现大约半数的病人术后10到15年后静脉移植体会有不同程度的增生再狭窄甚至阻塞,引发严重的后果.因此,深入了解静脉体进入动脉循环环境后的病变过程及其机制具有重要意义.文章介绍了正常血管的发育与调控,比较动、静脉血管生理差异,讲述静脉移植后动脉化及再狭窄的病理过程,分析各种病变的影响因素及作用机制并展望未来各种治疗前景.

Pathogenesis and Mechanism of Vein Graft Disease

Coronary artery bypass grafting(CABG)is a highly effective method in the treatment of coronary heart disease(CAD).However,its effectiveness is impeded by the limited life expectancy of vein grafts,which are the most common types of conduits used.Many reports presented follow-up angiographic data on large cohorts of patients,demonstrating that approximately one-half of vein grafts fail within 10 to 15 years of surgery and that graft failure is associated with worse clinical outcomes.Therefore,understanding the venous-specifc pathophysiological and molecular mechanisms of vein graft adaptation is important for clinical vein graft management.This overview describes the normal development and regulation of vessel,compares the differences between artery and vein,introduces the adaptive response of vein graft to the arterial environment during the post-surgical process and its molecular mechanism,and discusses various therapeutic prospects.