冠状动脉易损斑块愈合的新进展  

New advances in the healing of vulnerable coronary plaques

作　　者：杨芙蓉 蔡雅杰 于燕乔 范晓迪[1,4] 白瑞娜[1,2] YANG Furong;CAI Yajie;YU Yanqiao;FAN Xiaodi;BAI Ruina(Cardiovascular Disease Center,Xiyuan Hospital,China Academy of Chinese Medicine,Beijing 100091;National Clinical Research Center for Chinese Medicine Cardiology,Beijing 100091;Graduate School,Beijing University of Chinese Medicine,Beijing 100105;Institute of Traditional Chinese Medicine Pharmacology,China Academy of Chinese Medicine,Beijing 100007,China)

机构地区：[1]中国中医科学院西苑医院心血管病中心,北京100091 [2]国家中医心血管病临床医学研究中心,北京100091 [3]北京中医药大学研究生院,北京100105 [4]中国中医科学院中药药理研究所,北京100007

出　　处：《临床与病理杂志》2024年第6期883-890,共8页Journal of Clinical and Pathological Research

基　　金：国家自然科学基金(82174216)。

摘　　要：易损斑块愈合是急性冠状动脉综合征(acute coronary syndrome,ACS)的重要保护机制。易损斑块破裂或侵蚀引起的血小板聚集、血栓形成是斑块愈合的先决条件,局部血栓溶解、肉芽组织生成、血管再内皮化实现血管再通可形成亚临床状态,截断ACS的病理进程。大量临床数据提示愈合的斑块可能与患者的亚临床病变稳定化相关,但其具有较高的血管炎症水平及斑块易损性等不稳定特征,提示早期干预治疗是促进斑块愈合的重要手段。氧化三甲胺、脑源性神经营养因子等生物标志物可提示斑块愈合情况,及时给予稳定斑块、促进易损斑块愈合的治疗,可为预防ACS发病及死亡提供新思路。The healing of vulnerable plaques is a crucial protective mechanism against acute coronary syndrome(ACS).Plaque rupture or erosion leading to platelet aggregation and thrombus formation is a prerequisite for plaque healing.Local thrombus dissolution,granulation tissue formation,and re-endothelialization of the vessel,achieving vascular recanalization,can result in a subclinical state that interrupts the pathological progression of ACS.Extensive clinical data suggest that healed plaques may be associated with the stabilization of subclinical lesions in patients;however,they also exhibit high levels of vascular inflammation and plaque vulnerability,indicating that early intervention is a key strategy to promote plaque healing.Biomarkers such as trimethylamine N-oxide and brain-derived neurotrophic factor can indicate the status of plaque healing.Timely treatment aimed at stabilizing plaques and regulating the healing of vulnerable plaques may provide new approaches to preventing the onset of ACS and reducing mortality.

关 键 词：斑块愈合 易损斑块 斑块破裂 斑块侵蚀 急性冠状动脉综合征 

分 类 号：R541.4[医药卫生—心血管疾病]