组织因子途径抑制因子与肝脏疾病

Tissue factor pathway inhibitor and liver diseases

组织因子途径抑制因子(tissue factor pathway inhibitor,TFPI)是一种丝氨酸蛋白酶抑制物,主要由微血管内皮细胞合成,通过调节组织因子依赖的外源性凝血途径来发挥抗凝作用,并与抗炎、缺血性心脏病及恶性肿瘤等密切相关.在慢性肝病、肝硬化患者早期,肝脏微血管内皮细胞受到持续应激、感染和炎性刺激,组织因子过度表达,TFPI反馈性增高.在严重肝病或肝硬化并发门静脉血栓形成(portal vein thrombosis,PVT)时,TFPI由于大量消耗而降低.重组TFPI可预防PVT形成、降低弥散性血管内凝血的死亡率及改善炎症感染,为临床上预防和治疗肝硬化及并发症提供了新的思路.

Tissue factor pathway inhibitor （TFPI） is a proteinase inhibitor that is synthesized by microvascular endothelial cells and can primarily exert anticoagulant and anti-inflammatory effects. In chronic liver disease and early liver cirrhosis, tissue factors are excessively expressed due to continuous stress, infections and inflammatory stimulation in liver microvascular endothelial cells, which may lead to the rise of TFPI concentration. In severe liver disease and liver cirrhosis complicated with portal vein thrombosis （PVT）, the level of TFPI may decline for massive consumption. Recombinant TFPI （rTFPI） can effectively protect against PVT, reduce the mortality of disseminated or diffuse intravascular coagulation and improve inflammation. Understanding of the role of TFPI in liver diseases may provide potential strategy for the prevention and treatment of liver cirrhosis and its complications.