冠状动脉钙化病理分类及相关分子机制研究进展  

Research progress in pathological classification and related molecular mechanisms of coronary artery calcification

作　　者：张礼潜 聂文畅 柏宝辰 刘健[1] ZHANG Li-qian;NIE Wen-chang;BAI Bao-chen;LIU Jian(Department of Cardiology,Peking University People’s Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院心内科,北京100044

出　　处：《中国介入心脏病学杂志》2023年第10期764-769,共6页Chinese Journal of Interventional Cardiology

基　　金：北京大学人民医院研究与发展基金(2147000554)。

摘　　要：冠状动脉钙化(CAC)是指钙盐在冠状动脉血管壁中的异常沉积。CAC病变发生率高,术后相关并发症多,且预后较差,一直是冠状动脉介入治疗的重难点。探究钙化成因及进展机制可为CAC的防治提供新靶点。近年来钙化机制相关研究表明,动脉粥样硬化炎症介导的CAC主要在内膜进展。其中,介导发育稳态的胞内Wnt/β-catenin通路、介导骨形成的OPG/RANK/RANKL通路以及骨形态发生蛋白2(BMP2)、AMP激活蛋白激酶(AMPK)及其下游信号通路都在钙化病变发展中发挥重要调节作用,靶向上述信号通路可能逆转钙化进展。本文从CAC的病理分类入手,梳理CAC发生的启动机制,并介绍了与CAC相关的主要分子信号通路以及不同病理类型的相关机制,旨在深化临床医师对CAC的认知,并为钙化病变诊疗拓展新思路。Coronary artery calcification(CAC)is the abnormal deposition of calcium salts in the walls of coronary arteries.CAC has a high incidence of disease,many postoperative complications and poor prognosis,which have always been major difficulties in percutaneous coronary intervention.Exploring the causes and progression mechanism of calcification can provide a new target for the prevention and treatment of CAC.Recent studies on the mechanism of calcification show that atherosclerotic inflammation mediated coronary calcification mainly develops in the intima.Intracellular Wnt/β-catenin pathway mediating developmental homeostasis,OPG/RANK/RANKL pathway mediating bone formation,bone morphogenetic protein family(BMPs),AMP-activated protein kinase(AMPK)and its downstream signaling pathways all play important regulatory roles in the development of calcification lesions.Targeting the aforementioned signaling pathways may reverse calcification progression.This paper starts with the pathological classification of CAC,sorts out the initiation mechanism of CAC and introduces the main molecular signaling pathways related to CAC and the related mechanisms of different pathological types,aiming to deepen the understanding of clinical workers on CAC and develop new ideas for the diagnosis and treatment of calcification lesions.

关 键 词：冠状动脉钙化 病理分类 形成机制 分子信号通路 

分 类 号：R541[医药卫生—心血管疾病]