• 1.云南省第二人民醫(yī)院普外科（昆明650021）;;
  • 2.重慶醫(yī)科大學(xué)附屬第一醫(yī)院血管外科（重慶400016）;

目的 探討血管內(nèi)皮細(xì)胞在動(dòng)脈粥樣硬化形成過程中的損傷機(jī)理。 方法復(fù)習(xí)相關(guān)文獻(xiàn)，對有關(guān)進(jìn)展進(jìn)行總結(jié)分析。 結(jié)果各種致病因素造成細(xì)胞因子生成增多，激活了控制細(xì)胞粘附分子表達(dá)的核因子-κB，進(jìn)而使細(xì)胞粘附分子表達(dá)增強(qiáng)，促進(jìn)單核細(xì)胞血管內(nèi)皮細(xì)胞為主的粘附形成增多，釋放大量炎性介質(zhì)(氧自由基及蛋白酶等)，不僅直接損傷血管內(nèi)皮細(xì)胞，并可以通過免疫機(jī)理使大量單核細(xì)胞及中性粒細(xì)胞與血管內(nèi)皮細(xì)胞粘附結(jié)合，進(jìn)一步損傷血管內(nèi)皮細(xì)胞。同時(shí)，受損的血管內(nèi)皮細(xì)胞由于膜結(jié)構(gòu)的改變引起抗動(dòng)脈抗體的產(chǎn)生以致補(bǔ)體系統(tǒng)被激活而加重了血管內(nèi)皮細(xì)胞的損傷，也促進(jìn)了動(dòng)脈粥樣硬化的發(fā)生和發(fā)展。結(jié)論正確認(rèn)識血管內(nèi)皮細(xì)胞在動(dòng)脈粥樣硬化發(fā)生、發(fā)展過程中受損機(jī)理，對于動(dòng)脈粥樣硬化的防治具有重要意義。

引用本文： 趙泉,鄧靖宇,羅開元,時(shí)德. 血管內(nèi)皮細(xì)胞在動(dòng)脈粥樣硬化中的損傷機(jī)理. 中國普外基礎(chǔ)與臨床雜志, 2004, 11(4): 325-327. doi: 復(fù)制

版權(quán)信息： ?四川大學(xué)華西醫(yī)院華西期刊社《中國普外基礎(chǔ)與臨床雜志》版權(quán)所有，未經(jīng)授權(quán)不得轉(zhuǎn)載、改編

1. Reiner Z, TedeschiReiner E. New information on the pathophysiology of atherosclerosis [J]. Lijec Vjesn, 2001; 123(1-2)∶26.
2. Steinberg D. Lewis A. Conner Memorial Lecture. Oxidative modification of LDL and atherogenesis [J]. Circulation, 1997; 95(4)∶1062.
3. Colome C, MartinezGonzalez J, Vidal F, et al. Small oxidative changes in atherogenic LDL concentrations irreversibly regulate adhesiveness of human endothelial cells: effect of the lazaroid U74500A [J].Atherosclerosis, 2000; 149(2)∶295.
4. Cockerill GW, Saklatvala J, Ridley SH, et al. Highdensity lipoproteins differentially modulate cytokineinduced expression of Eselectin and cyclooxygenase2 [J]. Arterioscler Thromb Vasc Biol, 1999; 19(4)∶910.
5. Khan BV, Harrison DG, Olbrych MT, et al. Nitric oxide regulates vascular cell adhesion molecule 1 gene expression and redoxsensitive transcriptional events in human vascular endothelial cells [J]. Proc Natl Acad Sci USA, 1996; 93(17)∶9114.
6. Keck C, Herchenbach D, Pfisterer J, et al. Effects of 17betaestradiol and progesterone on interleukin6 production and proliferation of human umbilical vein endothelial cells [J]. Exp Clin Endocrinol Diabetes, 1998; 106(4)∶334.
7. Walsh BA, Mullick AE, Banka CE, et al. 17betaestradiol acts separately on the LDL particle and artery wall to reduce LDL accumulation [J]. J Lipid Res, 2000; 41(1)∶134.
8. Spyridopoulos I, Sullivan AB, Kearney M, et al. Estrogen receptor mediated inhibition of human endothelial cell apoptosis. Estradiol as a survival factor [J]. Circulation, 1997； 95(6)∶1505.
9. Best PJ, Berger PB, Miller VM, et al. The effect of estrogen replacement therapy on plasma nitric oxide and endothelin1 levels in postmenopausal women [J]. Ann Intern Med, 1998; 128(4)∶285.
10. Simoncini T, Maffei S, Basta G, et al. Estrogens and glucocorticoids inhibit endothelial vascular cell adhesion molecule1 expression by different transcriptional mechanisms [J]. Circ Res, 2000; 87(1)∶19.
11. CaulinGlaser T, Farrell WJ, Pfau SE, et al. Modulation of circulating cellular adhesion molecules in postmenopausal women with coronary artery disease [J]. J Am Coll Cardiol, 1998; 31(7)∶1555.
12. Manduteanu L, Voinea M, Serban G, et al. High glucose induces enhanced monocyte adhesion to valvular endothelial cells via a mechanism involving ICAM1, VCAM1 and CD18 [J]. Endothelium, 1999; 6(4)∶315.
13. Kado S, Nagata N. Circulating intercellular adhesion molecule1, vascular cell adhesion molecule1, and Eselectin in patients with type 2 diabetes mellitus [J]. Diabetes Res Clin Pract, 1999; 46(2)∶143.
14. Ribau JC, Hadcock SJ, Teoh K, et al. Endothelial adhesion molecule expression is enhanced in the aorta and internal mammary artery of diabetic patients [J]. J Surg Res, 1999; 85(2)∶225.
15. Kol A, Bourcier T, Lichtman AH, et al. Chlamydial and human heat shock protein 60s activate human vascular endothelium, smooth muscle cells, and macrophages [J].J Clin Invest， 1999; 103(4)∶571.
16. Shen Y, Rattan V, Sultana C, et al. Cigarette smoke condensateinduced adhesion molecule expression and transendothelial migration of monocytes [J]. Am J Physiol, 1996; 270(5 Pt 2)∶H1624.
17. Rosenbaum J, Pottinger BE, Woo P, et al. Measurement and charactersation of circulating antiendothelial cell IgG connective tissue diseases [J]. Clin Exp Immunol, 1998; 72(3)∶450.
18. Kawana S. The membrane attack complex of complement alters the membrane integrity of cultured endothelial cells: a possible pathophysiology for immune complex vasculitis [J]. Acta Derm Venereol, 1996; 76(1)∶13.
19. Miyagawa S, Shirakura R, Mikata S, et al. Functional feature of C5b8step lysis of swine endothelial cell transfected CD59 [J]. Transplant Proc, 1996; 28(2)∶597.
20. McCurry KR, Kooyman DL, Diamond LE, et al. Transgenic expression of human complement regulatory proteins in mice results in diminished complement deposition during organ xenoperfusion [J]. Transplantation, 1995; 59(8)∶1177.
21. Li W, Tada T, Miwa T, et al. mRNA expression of complement components and regulators in rat arterial smooth muscle cells [J]. Microbiol Immunol, 1999; 43(6)∶585.
22. Seifert PS, Roth I, Schmiedt W, et al. CD59 (homologous restriction factor 20), a plasma membrane protein that protects against complement C5b9 attack, in human atherosclerotic lesions [J]. Atherosclerosis, 1992; 96(2-3)∶135.
  1. 1. Reiner Z, TedeschiReiner E. New information on the pathophysiology of atherosclerosis [J]. Lijec Vjesn, 2001; 123(1-2)∶26.
  2. 2. Steinberg D. Lewis A. Conner Memorial Lecture. Oxidative modification of LDL and atherogenesis [J]. Circulation, 1997; 95(4)∶1062.
  3. 3. Colome C, MartinezGonzalez J, Vidal F, et al. Small oxidative changes in atherogenic LDL concentrations irreversibly regulate adhesiveness of human endothelial cells: effect of the lazaroid U74500A [J].Atherosclerosis, 2000; 149(2)∶295.
  4. 4. Cockerill GW, Saklatvala J, Ridley SH, et al. Highdensity lipoproteins differentially modulate cytokineinduced expression of Eselectin and cyclooxygenase2 [J]. Arterioscler Thromb Vasc Biol, 1999; 19(4)∶910.
  5. 5. Khan BV, Harrison DG, Olbrych MT, et al. Nitric oxide regulates vascular cell adhesion molecule 1 gene expression and redoxsensitive transcriptional events in human vascular endothelial cells [J]. Proc Natl Acad Sci USA, 1996; 93(17)∶9114.
  6. 6. Keck C, Herchenbach D, Pfisterer J, et al. Effects of 17betaestradiol and progesterone on interleukin6 production and proliferation of human umbilical vein endothelial cells [J]. Exp Clin Endocrinol Diabetes, 1998; 106(4)∶334.
  7. 7. Walsh BA, Mullick AE, Banka CE, et al. 17betaestradiol acts separately on the LDL particle and artery wall to reduce LDL accumulation [J]. J Lipid Res, 2000; 41(1)∶134.
  8. 8. Spyridopoulos I, Sullivan AB, Kearney M, et al. Estrogen receptor mediated inhibition of human endothelial cell apoptosis. Estradiol as a survival factor [J]. Circulation, 1997； 95(6)∶1505.
  9. 9. Best PJ, Berger PB, Miller VM, et al. The effect of estrogen replacement therapy on plasma nitric oxide and endothelin1 levels in postmenopausal women [J]. Ann Intern Med, 1998; 128(4)∶285.
  10. 10. Simoncini T, Maffei S, Basta G, et al. Estrogens and glucocorticoids inhibit endothelial vascular cell adhesion molecule1 expression by different transcriptional mechanisms [J]. Circ Res, 2000; 87(1)∶19.
  11. 11. CaulinGlaser T, Farrell WJ, Pfau SE, et al. Modulation of circulating cellular adhesion molecules in postmenopausal women with coronary artery disease [J]. J Am Coll Cardiol, 1998; 31(7)∶1555.
  12. 12. Manduteanu L, Voinea M, Serban G, et al. High glucose induces enhanced monocyte adhesion to valvular endothelial cells via a mechanism involving ICAM1, VCAM1 and CD18 [J]. Endothelium, 1999; 6(4)∶315.
  13. 13. Kado S, Nagata N. Circulating intercellular adhesion molecule1, vascular cell adhesion molecule1, and Eselectin in patients with type 2 diabetes mellitus [J]. Diabetes Res Clin Pract, 1999; 46(2)∶143.
  14. 14. Ribau JC, Hadcock SJ, Teoh K, et al. Endothelial adhesion molecule expression is enhanced in the aorta and internal mammary artery of diabetic patients [J]. J Surg Res, 1999; 85(2)∶225.
  15. 15. Kol A, Bourcier T, Lichtman AH, et al. Chlamydial and human heat shock protein 60s activate human vascular endothelium, smooth muscle cells, and macrophages [J].J Clin Invest， 1999; 103(4)∶571.
  16. 16. Shen Y, Rattan V, Sultana C, et al. Cigarette smoke condensateinduced adhesion molecule expression and transendothelial migration of monocytes [J]. Am J Physiol, 1996; 270(5 Pt 2)∶H1624.
  17. 17. Rosenbaum J, Pottinger BE, Woo P, et al. Measurement and charactersation of circulating antiendothelial cell IgG connective tissue diseases [J]. Clin Exp Immunol, 1998; 72(3)∶450.
  18. 18. Kawana S. The membrane attack complex of complement alters the membrane integrity of cultured endothelial cells: a possible pathophysiology for immune complex vasculitis [J]. Acta Derm Venereol, 1996; 76(1)∶13.
  19. 19. Miyagawa S, Shirakura R, Mikata S, et al. Functional feature of C5b8step lysis of swine endothelial cell transfected CD59 [J]. Transplant Proc, 1996; 28(2)∶597.
  20. 20. McCurry KR, Kooyman DL, Diamond LE, et al. Transgenic expression of human complement regulatory proteins in mice results in diminished complement deposition during organ xenoperfusion [J]. Transplantation, 1995; 59(8)∶1177.
  21. 21. Li W, Tada T, Miwa T, et al. mRNA expression of complement components and regulators in rat arterial smooth muscle cells [J]. Microbiol Immunol, 1999; 43(6)∶585.
  22. 22. Seifert PS, Roth I, Schmiedt W, et al. CD59 (homologous restriction factor 20), a plasma membrane protein that protects against complement C5b9 attack, in human atherosclerotic lesions [J]. Atherosclerosis, 1992; 96(2-3)∶135.