血管重构及其药物治疗

Vascular Remodeling and Medical Treatment

血管重构是血管为适应内外环境变化而发生的结构和功能改变。这个过程包括血管壁细胞的增生、肥大、凋亡、细胞迁移、细胞外基质的产生及降解等细胞生物学变化。血管重构可分为肥厚性血管重构与非肥厚性血管重构,两者以一定比例共存于同一血管上。非肥厚性血管重构的主要特征是血管外径明显减少、内径明显减少,中膜横截面积不变,血管平滑肌细胞发生重排;肥厚性血管重构的主要特征是内径明显减少,中膜横截面积增加,血管平滑肌细胞增生。血管重构既是高血压和动脉粥样硬化等相关疾病恶化的重要病理基础或也是此类疾病发生发展的病因。药物治疗不仅要缓解或消除相关疾病的症状,更重要的是逆转或减轻血管重构,保护靶器官。

Vascular remodeling is an active adaptive process of vascular function and structure, which involves cell growth, apoptosis, cell migration, and production or degradation of extracellular matrix in the vascular wall. Vascular remodeling includes hypertrophic remodeling and non-hypertrophic remodeling, which coexist in the same vascular wall with a certain proportion. The characteristics of non-hypertrophic remodeling include decrease of external diameter and internal diameter, no change of media area and rearrangement of vascular smooth muscle cells, while the hypertrophic remodeling has the characteristics of the reduction of internal diameter, the increase of media area and vascular smooth muscle cells hyperplasia. Vascular remodeling is the pathological basis and cause of the occurrence and aggravation of such diseases as hypertension, atherosclerosis, and restenosis after angioplasty. Therefore, the aim of drug treatment not only relieve the symptoms of related diseases, but also regress vascular remodeling and prevent from organic damage of heart, kidney and brain. The familiar drugs of regressing vascular remodeling include angiotensin converted-enzyme inhibitor, angiotensin II receptor blocker, blocker of calcium ion channels, opener of potassium ion channels, blocker of endothelin receptor, anti--oxidated substances, herbal medicine and so on. The exploitation of herbal medicine will have a good future in the regression of vascular remodeling.