AECOPD合并VTE发病机制的研究进展

秦 莉1, 汪元 浚*2
1、青海大学研究生院
2、青海大学附属医院全科医学科

摘要


慢性阻塞性肺疾病急性加重期（Acute Exacerbation of Chronic Obstructive Pulmonary Disease，AECOPD）患者因全身炎症反应、内皮损伤及凝血-纤溶失衡，显著增加静脉血栓栓塞症（Venous Thromboembolism，VTE）风险。本文基于Virchow血栓形成三要素（血液淤滞、高凝状态、血管损伤），系统探讨AECOPD合并VTE的多维度病理机制：炎症因子（如IL-6、TNF-α）通过激活单核细胞-血小板相互作用及上调组织因子（Tissue Factor，TF）表达，驱动凝血级联反应；内皮功能障碍导致抗凝蛋白（如血栓调节蛋白）减少及血管性血友病因子（von Willebrand Factor，vWF）蓄积，加剧促凝-抗凝失衡；缺氧及氧化应激通过诱导HIF-1α稳定化，促进红细胞生成及血液黏稠度增加，进一步加重静脉淤滞。此外，血小板活化、纤溶系统抑制及细胞外囊泡（Extracellular Vesicles，EVs）的促凝作用共同构成血栓形成的复杂网络。本文旨在为AECOPD患者VTE的早期识别和精准干预提供理论依据。

关键词


AECOPD；静脉血栓栓塞症；炎症-凝血互作；内皮损伤；细胞外囊泡

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参考


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