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“内皮功能障碍”是指各种以内皮功能巨大改变,细胞表型从静止状态转变到激活状态为特征的综合征。目前尚无“内皮功能障碍”的明确定义,并且这种异常状态实际上包含一系列血管舒缩反应、抗血栓形成、血管通透性、白细胞募集、内皮细胞增殖等功能失调。临床中可通过无创性试验发现内皮细胞功能障碍,如乙酰胆碱等药物或远端小管一过性缺血后继发血管扩张等因素均会影响血管舒缩反应[1]。大量研究关注于探索有关内皮功能障碍的循环标志物,其中包括内皮素1(ET-1),一氧化氮代谢产物(亚硝酸盐、硝酸盐),纤溶及抗凝活性标志物(纤溶酶原激活因子抑制因子1、可溶性血栓调节蛋白),以及可溶性内皮黏附分子(可溶性E-选择素(s-E-selectin)、可溶性细胞间黏附分子(s-ICAM)、可溶性血管细胞间黏附分子(s-VCAM))[2]。近来提出将循环内皮细胞、内皮细胞微粒和内皮祖细胞作为内皮细胞功能障碍的替代标志物[3]。
“Endothelial dysfunction” refers to a variety of syndromes characterized by a dramatic change in endothelial function and a change in the phenotype of the cell from a resting state to an activated state. There is no clear definition of “endothelial dysfunction”, and this abnormal state actually contains a series of dysfunctional effects of vasomotor, antithrombosis, vascular permeability, leukocyte recruitment and endothelial cell proliferation. Clinical non-invasive test found endothelial cell dysfunction, such as acetylcholine and other drugs or distal tubular transient ischemic secondary vasodilation and other factors will affect the vasomotor response [1]. A number of studies have focused on the discovery of circulating markers of endothelial dysfunction including endothelin 1 (ET-1), nitric oxide metabolites (nitrites, nitrates), fibrinolysis and anticoagulant activity markers (SE-selectin), soluble intercellular adhesion molecule (s-ICAM), soluble vascular cell adhesion molecule (s-ICAM) and soluble vascular cell adhesion molecule -VCAM)) [2]. Recently proposed the use of circulating endothelial cells, endothelial cell particles and endothelial progenitor cells as a surrogate marker of endothelial dysfunction [3].