斑块愈合在动脉粥样硬化发展中的作用

The role of plaque healing in the development of atherosclerosis

动脉粥样硬化斑块的破裂或侵蚀、血栓形成是导致急性冠状动脉综合征(ACS)的主要原因,但病理研究显示许多不稳定动脉粥样硬化斑块并不导致临床症状,这一模式可能过于简化了斑块进展及ACS发展的过程。随着光学相干断层扫描技术(OCT)、血管内超声(IVUS)等腔内影像技术在ACS中的应用,不同斑块特征得到更深入的研究。动脉粥样硬化斑块的不稳定和愈合之间失衡的机制以及斑块愈合在ACS形成过程中的作用日益受到重视。本篇综述旨在探讨斑块愈合在动脉粥样硬化斑块的进展、ACS的发展中的作用,炎症、血栓、肉芽组织、内皮细胞形成等在斑块愈合中相关机制及临床和潜在的干预方向。

Atherosclerotic plaque rupture or erosion with thrombosis is the leading cause of acute coronary syndrome(ACS),but pathological studies have shown that many unstable atherosclerotic plaques do not lead to clinical symptoms,and this model may oversimplify plaque progression and the development of ACS.With the application of intracavitary imaging techniques such as optical coherence tomography(OCT)and intravascular ultrasound(IVUS)in ACS,different plaque characteristics have been more deeply studied.The mechanism of imbalance between instability and healing of atherosclerotic plaques and the role of plaque healing in the development of ACS have attracted increasing attention.The article reviews the role of plaque healing in the progression of atherosclerotic plaques and the development of ACS,and the mechanisms of inflammation,thrombosis,granulation tissue and endothelial cell formation related to plaque healing as well as clinical and potential intervention directions.