冠状动脉钙化的机制研究进展

The progression about the mechanism of coronary artery calcification

冠状动脉钙化在动脉粥样硬化晚期出现,是冠状动脉粥样硬化的标志,也与临床意义上的冠状动脉疾病相关.临床检测到的钙化程度能反映斑块稳定状态,且能预测未来的心血管事件.冠状动脉钙化在病理上始于微钙化,然后生长成较大的钙碎片,最终导致片状沉积,这种演变与斑块的进展同时发生.本综述系统总结了冠状动脉启动钙化的两种细胞机制,并归纳了参与影响钙化进程的调节因素,同时重点讨论脂蛋白(α)和维生素K如何参与调节钙化进程,还总结了现有的特异性药物治疗以及潜在靶点,为防治冠状动脉钙化以及预防心血管事件提供了一定参考价值.

Coronary artery calcification(CAC)appears in the late stage of atherosclerosis,which was not only a sign of coronary atherosclerosis,but also related to coronary artery disease(CAD)in clinical practice.The degree of calcification detected by coronary CT could reflect the state of plaque and predict future cardiovascular events.Coronary artery calcification begins pathologically with microcalcification(0.5-15.0 mm)and then grows into larger calcium fragments,resulting in flaky deposition finally(>3 mm).This evolution occured at the same time as plaque progression.In this review,the authors describe the two cellular mechanisms of the initiation of CAC and disscuss the regulatory factors involved in the process of calcification,with specifically focused on lipoprotein(a)[Lp(a)]and vitamin K.In addition,the existing specific drug therapy and potential targets are summarized provide a certain value for the treatment of CAC and the prevention of following cardiovascular events.