ТРОМБОТИЧЕСКИЕ И ТРОМБОЭМБОЛИЧЕСКИЕ ОСЛОЖНЕНИЯ ПРИ СИСТЕМНЫХ ВАСКУЛИТАХ

Евгений Арсеньев, С. В. Тополянская
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引用次数: 2

Abstract

Nowadays, there is no doubt about the relationship between immune inflammation and the development of thrombosis due to the similarity of many pathogenetic machanisms underlying both pathological processes. Systemic vasculitis, along with other immuno- mediated inflammatory diseases, represent one of the most clear examples of such interaction. Thrombotic complications remain one of the most serious and life-threatening conditions that occur in patients with autoimmune diseases, in particular systemic vasculitis. This serves as powerful stimulus for studing the problem of hypercoagulation, which often accompanies the course of systemic vasculitis. Of interest are thrombosis that occure both in the injury of large vessel and in the involvement of medium and small vessels in the pathological process. According to the literature, thrombotic and thromboembolic complications are most common in ANCA-associated vasculitis and Behcet’s disease. This review discusses current studies regarding features of clinical picture and mechanisms of thrombosis development in systemic vasculitis. Because of these studies it became clear that for some vasculitis a high frequency of both arterial and venous thrombosis is characteristic. At the same time, other vasculitis are accompanied by high risk of only venous thrombosis. Finally, thrombosis and thromboembolism are quite rare complications for some vasculitis. Among the presented mechanisms of thrombosis involvement, disruptions of the hemostasis are widely considered. For examples, the presents the results of researches, which is actively discussed the role of neutrophil extracellular traps and antiendothelial cell antibodies in the development on thrombotic complictions. Special attention is paid to the possible role of some disorders of hemostasis, such as polymorphism V coagulation factor G1691FA and prothrombin G20210A. To search for literature sources, the following queries were used: “vasculitis”, “thrombosis”, “neutrophil extracellular traps”, “ANCA-associated vasculitis”, “venous thrombosis”, “arterial thrombosis”, “Behcet’s disease”, “Takayasu arteritis”, “granulomatosis with polyangiitis”, “eosinophilic granulomatosis with polyangiitis”, “Mmicroscopic polyangiitis”, “Henoch–Schonlein purpura”, “Kawasaki disease”, “polyarteritis nodosa”, “giant cell arteritis”, “Buerger’s disease”. In addition, use similar requests in English. The search was carried out in PubMed.
系统性血管炎血栓和血栓栓塞并发症
目前,免疫炎症与血栓形成之间的关系是毋庸置疑的,因为这两个病理过程的许多发病机制是相似的。系统性血管炎,连同其他免疫介导的炎症性疾病,是这种相互作用最明显的例子之一。血栓性并发症仍然是自身免疫性疾病,特别是全身性血管炎患者中最严重和危及生命的疾病之一。这为研究高凝问题提供了强有力的刺激,而高凝往往伴随着全身性血管炎的过程。血栓形成在病理过程中既发生在大血管损伤中,也发生在中小血管受累中。根据文献,血栓形成和血栓栓塞并发症在anca相关血管炎和白塞病中最常见。本文综述了目前关于全身性血管炎的临床特征和血栓形成机制的研究进展。由于这些研究,很明显,对于一些血管炎,高频率的动脉和静脉血栓形成是特征。同时,其他血管炎伴发高风险的只有静脉血栓形成。最后,血栓形成和血栓栓塞是一些血管炎相当罕见的并发症。在血栓形成的机制中,止血中断被广泛考虑。例如,介绍了研究结果,积极讨论了中性粒细胞胞外陷阱和抗内皮细胞抗体在血栓性并发症发生中的作用。特别关注一些止血障碍的可能作用,如多态性V凝血因子G1691FA和凝血酶原G20210A。为了检索文献来源,我们使用了以下查询:“血管炎”、“血栓形成”、“中性粒细胞胞外陷阱”、“anca相关性血管炎”、“静脉血栓形成”、“动脉血栓形成”、“白塞氏病”、“高松动脉炎”、“多血管炎肉芽肿病”、“嗜酸性肉芽肿病多血管炎”、“显微多血管炎”、“过敏性紫癜”、“川崎病”、“结节性多动脉炎”、“巨细胞动脉炎”、“伯格氏病”。此外,在英语中使用类似的请求。搜索是在PubMed上进行的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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