斑块侵蚀发病机制的最新研究进展

斑块侵蚀是导致急性冠脉综合征的另一重要原因,目前针对斑块侵蚀病变的发生和发展过程尚不清楚。血流紊乱会激活内皮细胞Toll样受体2,介导内皮细胞凋亡、剥脱,作为斑块侵蚀病变发生的启动因素。透明质酸和多功能蛋白聚糖代谢障碍、细胞外基质发生重构,在斑块侵蚀病变进程中发挥核心作用。中性粒细胞形成胞外诱捕网,释放细胞活性成分,进一步损伤内皮细胞,促进血栓形成。现主要从以上三方面对斑块侵蚀病变形成的可能机制及假说进行综述。

Pathogenic Mechanisms of Plaque Erosion

Plaque erosion is currently thought to be another important cause of acute coronary syndrome,yet we lack understanding of its mechanisms. The flow perturbation activates the Toll-like receptor 2 of endothelial cells and mediates the apoptosis and exfoliation of endothelial cells as the starting factors for the occurrence of plaque erosion lesions. Hyaluronic acid and multifunctional proteoglycan metabolic disorders,and reconstruction of extracellular matrix played the key roles in lesion process. Neutrophil extracellular traps formation appeared to contribute more prominently to release cellular active ingredients and further impaired endothelial cells. Thus,in this article,we reviewed the current mechanisms and hypotheses of plaque erosion mainly from the above three aspects.