人工心脏血液损伤风险评估模型综述  

Review on Hemocompatibility Risk Assessment Models for Artificial Heart

作　　者：李远 陈增胜[1] LI Yuan;CHEN Zengsheng(Key Laboratory of Biomechanics and Mechanobiology(Beihang University),Ministry of Education,Key Laboratory of Innovation and Transformation of Advanced Medical Devices,Ministry of Industry and Information Technology,National Medical Innovation Platform for Industry-Education Integration in Advanced Medical Devices Interdiscipline of Medicine and Engineering,School of Biological Science and Medical Engineering,Beihang University,Beijing 100191,China)

机构地区：[1]生物力学与力生物学教育部重点实验室,高端医疗装备与器械创新及转化工业和信息化部重点实验室,国家医学攻关(医工结合方向)高端医疗装备与器械产教融合创新平台,北京航空航天大学生物与医学工程学院,北京100191

出　　处：《医用生物力学》2025年第1期13-24,共12页Journal of Medical Biomechanics

基　　金：国家自然科学基金项目(12372300,U23A20486);北京市自然科学基金项目(L241031);国家重点研发计划项目(2020YFC0862902,2020YFC0862904);中央高校基本科研业务费;北京航空航天大学博士研究生卓越学术基金。

摘　　要：人工心脏作为终末期心力衰竭患者的重要治疗手段,其临床应用取得了显著成效。然而,由于机械泵血装置与血液直接接触,人工心脏的临床使用伴随着血栓形成和出血等血液损伤相关并发症,这些问题显著影响患者的治疗效果与预后。本文首先系统综述人工心脏引发血液损伤的机制,包括非生理剪切力导致的血小板激活、止血蛋白(如vWF)降解及血小板受体损伤的生物力学过程。然后,详细总结现有的血栓风险评估模型,包括血液淤积模型、血小板活化模型,以及基于凝血因子与止血蛋白动态变化的复杂数学模型。这些模型通过预测人工心脏诱导的血栓高风险区域,可为人工心脏设计优化和并发症防控提供指导。最后,介绍新近提出的人工心脏所致出血风险评估模型,出血风险模型与血栓风险模型相结合,可以构建更为全面的血液损伤评估系统模型。通过综述当前研究现状,旨在为人工心脏相关血液损伤的评估与预测提供参考,助力改善人工心脏血液相容性,提升人工心脏的安全性与临床疗效。As a critical treatment for patients with end-stage heart failure,artificial hearts have achieved significant clinical success.However,due to the direct contact between mechanical blood pumps and circulating blood,the clinical use of artificial hearts is often associated with blood damage-related complications such as thrombosis and bleeding,which significantly affect patient outcomes and prognosis.This paper first systematically reviews the mechanisms of blood damage induced by artificial hearts,including the biomechanical processes of platelet activation caused by non-physiological shear stress,von Willebrand factor(vWF)degradation,and platelet receptor impairment.Subsequently,existing thrombosis risk assessment models are summarized in detail,including blood stasis models,platelet activation models,and advanced mathematical models incorporating dynamic changes in coagulation factors and hemostatic proteins.These models predict high-risk thrombosis regions induced by artificial hearts,providing valuable guidance for device optimization and complication prevention.Finally,recently developed bleeding risk assessment models for artificial hearts are introduced.The integration of bleeding and thrombosis risk models enables the development of a more comprehensive hemocompatibility evaluation system.By reviewing the current research progress,this study aims to provide a reference for the assessment and prediction of blood damage in artificial hearts,contributing to improved hemocompatibility,enhanced safety,and better clinical outcomes of artificial heart devices.

关 键 词：人工心脏 数学模型 血栓 出血 剪切力 

分 类 号：R318.01[医药卫生—生物医学工程]