移植相关性血栓性微血管病诊治进展

Research Progress of Diagnosis and Treatment in Transplantation-Associated Thrombotic Microangiopathy——Review

移植相关性血栓性微血管病(transplantation associated thrombotic microangiopathy,TA-TMA)是造血干细胞移植的致死性并发症之一,其发病机制尚未完全阐明。最新的研究发现,补体系统的异常激活可引起广泛内皮损伤,并在TA-TMA的发病机制中起到重要作用。难以控制的高血压、蛋白尿、可溶性C5b-9的升高、移植早期发生心包积液等是TA-TMA发生的危险因素。本文就近年来TA-TMA的发病机制、早期诊断、治疗等方面的研究进展进行综述,为TA-TMA的早期诊断及治疗提供新思路。

Transplantation-associated thrombotic microangiopathy (TA-TMA) is one of the fatal complications of hematopoietic stem cell transplantation(HSCT).The pathogenesis of TA-TMA has not been fully elucidated.The latest researches show that the abnormal activation of the complement system may lead to widespread endothelial injury which may play an important role in the pathogenesis of this disease.Incontrotable hypertension, proteinuria, increase of soluble C5b-9 concentration and early pericardial effusion are the risk factors of TA-TMA .In this review, the latest advances of pathogenesis, early diagnosis, treatment and other aspects of the progress of TA-TMA are summarized, so as to provide new ideas to early diagnosis and treatment in TA-TMA.