脂蛋白a的促炎、促血栓形成机制及临床价值的研究进展

Research Progress on pro-inflammatory and thrombotic mechanisms of lipoprotein(a)and its clinical implication

脂蛋白a[lipoprotein(a),Lp(a)]是一种修饰的脂蛋白,主要由低密度脂蛋白样颗粒及载脂蛋白a[apolipoprotein(a),Apo(a)]所构成。已证明Lp(a)升高具有促动脉硬化作用;此外,其潜在的促炎、促血栓形成机制日益引起学界的关注。Apo(a)组分与纤溶酶原具有显著的同源性;并可以通过单核细胞活化、内皮功能障碍以及促进平滑肌细胞增殖参与炎症。多种降低Lp(a)的新型降脂药陆续被研发出来。本文主要从Lp(a)的结构出发,对Lp(a)的促炎、促血栓形成机制进行综述,并探讨其在临床应用中的价值。

Lipoprotein(a)[Lp(a)]is a modified lipoprotein mainly composed of low-density lipoprotein(LDL)like particles and apolipoprotein(a)[Apo(a)].In addition to promoting atherosclerosis,the potential mechanisms of promoting inflammation and thrombosis have attracted increasing attention.Apo(a)has significant homology with plasminogen,and participates in inflammation process through monocytes activation,endothelial dysfunction,and promotion of smooth muscle cell proliferation.New lipid-lowering drugs to reduce Lp(a)have been developed.This article reviews the pro-inflammatory and thrombotic mechanisms of Lp(a)based on its structure,and discusses its value of clinical applications.