异常血流动力学和血管重塑在泛血管疾病中的作用  

Role of abnormal hemodynamics and vascular remodeling in pan-vascu⁃lar diseases

作　　者：李月兴 李倩 陈波洋 陈帅 陈云志 LI Yuexing;LI Qian;CHEN Boyang;CHEN Shuai;CHEN Yunzhi(School of Basic Medicine,Guizhou University of Traditional Chinese Medicine,Guiyang 550025,China)

机构地区：[1]贵州中医药大学基础医学院,贵州贵阳550025

出　　处：《中国病理生理杂志》2024年第5期931-937,共7页Chinese Journal of Pathophysiology

基　　金：国家自然科学基金资助项目(No.82260890);滚动支持省属高校科研平台团队项目(黔教技[2022]-023)。

摘　　要：血管重塑(vascular remodeling,VR)是一种涉及血管细胞类型、形态及功能变化的过程,可分为生理性重塑和病理性重塑。生理性重塑是为了在扰动发生后恢复内环境平衡,而病理性重塑的关键在于变量一直存在,能对人体造成持续性损害^([1-2])。血流动力学是一种涵盖血流量、血流阻力、血压及其相互关系的生物力学,可对血管组织造成持续影响^([3])。异常血流动力学导致血管细胞功能障碍和非细胞成分改变,是VR发生的基本过程。泛血管疾病是人体静脉、动脉、淋巴管等血管系统出现病变的一大类疾病的统称^([4])。糖尿病、脂肪肝、肿瘤等代谢性疾病和新型冠状病毒肺炎(coronavirus disease2019,COVID-19)等感染性疾病均伴有血管病变,可归属于泛血管疾病范畴^([5])。研究表明,生理病理性VR可通过改变血流和病变部位的营养供应等影响泛血管疾病进展。Vascular remodeling is a physiological and pathological process in which abnormal changes in vas-cular cells and non-cellular components lead to the remodeling of inward and outward blood vessel wall or changes in lu-men diameter.As the channels for blood flow,blood vessels are continuously affected by hemodynamic forces.When sens-ing the abnormal blood flow forces,the mechanically sensitive cell membrane structures such as G protein-coupled recep-tors,ion channels,cell surface glycocalyx,and integrins,as well as the extracellular matrix will induce the process of vas-cular endothelial dysfunction,endothelial-mesenchymal transition,smooth muscle cell phenotypic switching,pericyte morphological changes and extracellular matrix remodeling to participate in vascular remodeling.As shown by research,abnormal hemodynamics caused abnormal changes in vascular structure and function,which was the basic process for the occurrence and development of pan-vascular diseases such as atherosclerosis,hypertension,diabetes,non-alcoholic fatty liver disease,pulmonary hypertension and COVID-19.This paper reviewed the interaction and molecular mechanism be-tween abnormal hemodynamics and vascular remodeling,and analyzed its influence on the pathogenesis of pan-vascular diseases,which could provide reference for formulating prevention and treatment strategies for pan-vascular diseases.

关 键 词：血管重塑 血流动力学 剪切应力 泛血管疾病 

分 类 号：R543[医药卫生—心血管疾病] R654[医药卫生—内科学] R363.2[医药卫生—临床医学]