摘要
肝硬化是全球范围内严重的公共健康问题,门静脉血栓形成(portal vein thrombosis,PVT)是其主要并发症之一。PVT显著影响患者的预后。近年来研究表明,中性粒细胞及其释放的中性粒细胞胞外捕网(neutrophil extracellular traps,NETs)在PVT的发生、发展中发挥关键作用。NETs通过促进凝血因子激活、血小板聚集及纤维蛋白沉积加速血栓形成,同时增强血栓稳定性,增加溶栓治疗难度。此外,干扰素通过诱导中性粒细胞活化和NETs形成,可能对PVT产生双重影响。本文系统总结了中性粒细胞及NETs在肝硬化PVT形成中的机制,包括其对凝血系统、血管内皮功能及纤维蛋白网络动态调控的作用,同时探讨了如脱氧核糖核酸酶(DNase)降解、抗炎及抗凝治疗的联合应用等抑制NETs形成的潜在治疗策略。结合现有临床与实验研究结果,本文提出了针对NETs及中性粒细胞活性的个体化治疗思路,为优化肝硬化PVT的诊断及治疗提供新视角。
Liver cirrhosis is a severe global public health issue,with portal vein thrombosis(PVT)being one of its major complications.PVT significantly impacts patient prognosis.Recent studies have demonstrated that neutrophils and their released neutrophil extracellular traps(NETs)play a crucial role in the development and progression of PVT.NETs accelerate thrombosis by promoting coagulation factor activation,platelet aggregation,and fibrin deposition while enhancing thrombus stability,thereby increasing the difficulty of thrombolytic therapy.Additionally,interferon,by inducing neutrophil activation and NETs formation,may exert dual effects on PVT.This article systematically summarizes the mechanisms by which neutrophils and NETs contribute to the formation of cirrhosis-related PVT,including their regulation of coagulation systems,vascular endothelial functions,and fibrin network dynamics.Furthermore,potential therapeutic strategies targeting NETs,such as DNase degradation,anti-inflammatory treatments,and combined anticoagulant therapies,are discussed.Based on current clinical and experimental findings,this article proposes personalized therapeutic approaches targeting NETs and neutrophil activity,providing new perspectives for optimizing the diagnosis and treatment of cirrhosis-related PVT.
作者
陈纪宏
林果
尹宇航
赵浩南
刘壮
祁兴顺
CHEN Jihong;LIN Guo;YIN Yuhang;ZHAO Haonan;LIU Zhuang;QI Xingshun(Department of Gastroenterology,General Hospital of Northern Theater Command,Shenyang,110840,China;Graduate School of Dalian Medical University;Graduate School of China Medical University;Department of Life Sciences and Biopharmaceutis,Shenyang Pharmaceutical University)
出处
《中国中西医结合消化杂志》
CAS
2024年第12期1065-1070,共6页
Chinese Journal of Integrated Traditional and Western Medicine on Digestion
基金
国家自然科学基金(No:82270659)。
