在破裂的动脉硬性斑块上形成血栓,在演变的血栓上形成逆血栓
L Badimon1, J H Chesebro, J J Badimon
1Cardiovascular Biology Research, Massachusetts General Hospital, Harvard Medical School, Boston 02114.
Circulation
|December 1, 1992
概括
在冠状动脉疾病中,斑块破裂导致血栓形成. 局部和系统因素会影响这个过程,剩余的血栓会导致再封闭,即使使用抗凝药.
科学领域:
- 心血管研究研究心血管研究
- 血栓形成和血液静止.
- 动脉样硬化病原体的产生
背景情况:
- 不稳定的心痛和心肌梗塞通常涉及异常的冠状动脉狭窄,边界不规则,表明动脉样板破裂和血栓形成.
- 血管镜和尸检证实斑块破裂和血栓形成是急性冠状动脉综合征的关键事件.
研究的目的:
- 研究动脉硬性斑块破裂后影响血栓发生的局部和系统因素.
- 了解残留血栓在重新封闭中的作用和抗凝药的疗效.
主要方法:
- 模拟斑块破裂和血栓形成,使用ex vivo输液室.
- 在体内猪模型中研究了血栓形成过程.
- 利用复合希鲁丁来研究血栓在转血栓形成中的作用.
主要成果:
- 斑块破裂暴露了基板,导致与损伤成比例的血栓形成.
- 在狭窄性病变中,高剪切率可增强血小板沉积和血栓生长.
- 像上腺素,胆固醇和纤维素分解受损等系统性因素可以增加血栓发生力.
- 剩余的血栓对重新封闭有显著的作用,即使在肝素化血液中也是如此.
- 在原始血栓内与纤维素结合的血栓在转血栓形成中起作用.
结论:
- 当地血管壁因素 (暴露基质,流体动力学) 和系统因素 (荷尔蒙,脂质,纤维解) 在斑块破裂后关键调节血栓性.
- 剩余的血栓是一个强大的血栓生成表面,有助于重新封闭.
- 向与纤维素结合的血栓可能是防止重新封闭的策略.
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