硫酸吲哚酚促进慢性肾脏病患者急性冠脉综合征机制的研究进展

Research progress on the mechanism of indoxyl sulfate promoting acute coronary syndrome in patients with chronic kidney disease

急性冠脉综合征(ACS)是慢性肾脏病(CKD),尤其是尿毒症患者的主要死亡原因之一。ACS形成的主要原因与血管内皮功能损伤引起的动脉粥样硬化和动脉内血栓形成密切相关。硫酸吲哚酚(IS)是色氨酸在肠道细菌作用下的代谢产物,CKD患者,尤其是尿毒症患者,IS不能有效排出体外造成人体内蓄积而从多个方面造成内皮功能损伤并在ACS发生发展中发挥重要作用。本文主要对近年来国内外有关IS引起CKD患者内皮损伤和血栓形成机制的最新进展进行综述,并总结目前在CKD患者中减轻IS引起的ACS方面的新措施,为防治CKD患者心血管事件提供帮助。

Acute coronary syndrome(ACS)is one of the leading causes of death in patients with chronic kidney disease(CKD),especially in uremic patients,and the main causes of ACS are atherosclerosis and intra-arterial thrombosis due to endothelial damage.Indoxyl sulfate(IS)is a metabolite of tryptophan under the action of intestinal bacteria.In CKD patients,especially in uremic patients,IS cannot be excreted effectively,causing accumulation in the body and causing endothelial function damage in several ways and playing an important role in the development of ACS.In this paper,we review the recent progress of endothelial injury and thrombosis mechanisms in CKD patients caused by IS,and summarize the new measures to mitigate IS-induced ACS in CKD patients,in order to help prevent and treat cardiovascular events in CKD patients.