脂蛋白(a)在钙化性主动脉瓣疾病中的作用研究进展

Research Progress of Role of Lipoprotein(a)in Calcific Aortic Valve Disease

临床中钙化性主动脉瓣疾病(CAVD)既常见又复杂,其曾被认为是一种“退行性”疾病,与脂质沉积、分子信号通路炎症过程关系密切,是一种主动的细胞驱动性疾病。CAVD与动脉粥样硬化性疾病在起始阶段有相似的病理生理轴,与血脂异常关系密切。近年来,脂蛋白(a)[Lp(a)]作为心血管疾病发病残余风险的重要因素越来越被重视,编码Lp(a)的LPA基因变异与CAVD的相关性也得到研究证实,针对Lp(a)的特异性药物治疗也在研制中。长期以来,CAVD没有有效的药物治疗方法,晚期行换瓣手术是其唯一有效治疗手段。因此对CAVD的发病机制进行深入探索,证实血脂尤其是Lp(a)水平升高与CAVD发生进展密切相关,可能成为未来其药物治疗的新方向。

Calcific aortic valve disease(CAVD),a common and complex disease in clinic,which was once considered as a"degenerative"disease,is related to lipid deposition and molecular signaling pathway inflammation and is an active cell driven disease.CAVD has a similar pathophysiological axis with atherosclerotic diseases in the initial stage and is closely related to dyslipidemia.In recent years,lipoprotein(a)[Lp(a)]as an important risk factor of residual of cardiovascular disease has been paid more and more attention,the correlation between LPA gene variation and CAVD has also been confirmed by studies,and specific drug therapy for Lp(a)is also in development.For a long time,there has been no effective drug treatment for CAVD,and valve replacement surgery is the only effective treatment for CAVD.Therefore,to explore the pathogenesis of CAVD and confirm that the increase of blood lipid,especially Lp(a)level,is closely related to the occurrence and progress of CAVD,may become a new direction of drug treatment in the future.