心脏淋巴管的分布、功能和病理意义

Distribution,function and pathologic impacts of cardiac lymphatic vessels

心脏淋巴引流对于维持心肌内微环境稳定起着重要作用。在心肌梗死和心力衰竭等疾病,淋巴管损伤或功能障碍可引起心脏淋巴水肿,从而导致心肌纤维化,加重炎症反应和严重影响心功能。近年来,人们对于心脏淋巴水肿与心脏疾病的相互关系以及心脏淋巴管新生的生理、病理意义的研究非常重视。靶向刺激心脏淋巴管新生可作为缓解心脏淋巴水肿的可靠疗法。然而,刺激心脏淋巴管新生的优化策略有待深入研究。本文主要综述心脏淋巴管的分布和功能特点,讨论心脏淋巴水肿的病理作用,心脏淋巴管新生的机制以及促进心脏淋巴管新生的措施和临床意义。

Drainage of lymph plays an important role in maintaining homeostasis of the myocardium.In heart diseases such as myocardial infarction and heart failure,injure or dysfunction of the lymphatic vessels result in cardiac lymphedema,leading to cardiac fibrosis,inflammation and cardiac dysfunction.In recent years,more attention has been put on studying relation of cardiac lymphedema with heart diseases and physiopathologic impacts of cardiac lymphangiogenesis.Targeting cardiac lymphangiogenesis is regarded as a feasible therapy for relieving cardiac lymphedema.However,the optimized strategies to sustainedly release growth factors or drugs and to transplant stem/progenitor cells need to be investigated.This article reviews mainly the characteristics of the distribution and function of the cardiac lymphatic vessels,and discusses the pathologic affects of cardiac lymphedema,the mechanisms of cardiac lymphangiogenesis and clinical impacts of promoting cardiac lymphangiogenesis.