血小板减少机制的研究进展

吴 景珠, 王 雪妮, 张 红
山东第一医科大学第二附属医院血液科

摘要


血小板减少症是临床常见的出血性疾病，其发病机制涉及血小板生成及破坏等多个环节的失衡。本文从分
子调控、免疫反应及糖蛋白修饰三个维度综述了其核心病理机制。在生成障碍方面，PI3K/AKT/mTOR信号通路通
过调控巨核细胞的倍性化及细胞质体积，直接影响血小板的产出效率，病毒干扰该通路可导致生成受阻。在破坏方
面，细胞因子风暴通过引发全身性炎症并抑制骨髓造血功能，加速血小板消耗。同时血小板膜表面去唾液酸化增强
介导血小板的快速清除。深入解析上述机制，有助于为血小板减少症的靶向治疗提供理论依据。

关键词


血小板减少症；PI3K/AKT/mTOR通路；细胞因子风暴；去唾液酸化

全文:

PDF


参考


[1]JIANG H, ZHANG L, YANG M, et al. Branchedchain amino acids promote thrombocytopoiesis by activating

mTOR signaling[J]. J Thromb Haemost, 2023, 21(11): 3224-

3235.

[2]DRAYER A L, OLTHOF S G, VELLENGA

E. Mammalian target of rapamycin is required for

thrombopoietin-induced proliferation of megakaryocyte

progenitors[J]. Stem Cells, 2006, 24(1): 105-114.

[3]DI BUDUO C A, CURRAO M, PECCI A,

et al. Revealing Eltrombopag’s promotion of human

megakaryopoiesis through AKT/ERK-Dependent pathway

activation[J]. Haematologica, 2016, 101(12): 1479-1488.

[4]LAHON A, ARYA R P, BANERJEA A C. Dengue

virus dysregulates master transcription factors and PI3K/AKT/

mTOR signaling pathway in megakaryocytes[J]. Front Cell

Infect Microbiol, 2021, 11: 715208.

[5]蒋会荣.不同表型来源的巨噬细胞膜仿生纳米粒

对细胞因子风暴的治疗效果研究[D].蚌埠医学院，2022.

[6]SADLER A J. A Viral NOD to encephalitis[J]. J

Virol, 2022, 96(13): e004542

[7]CHENG J, ZENG H, CHEN H, et al. Current

knowledge of thrombocytopenia in sepsis and COVID-19[J].

Front Immunol, 2023, 14: 1213510.

[8]NIRANJAN R, GANESH K. Role of cellular

mechanisms in dengue pathogenesis: focus on immune cells

interactions[J]. Comb Chem High Throughput Screen, 2025.

[9]王燕明.免疫性血小板减少症发病机制及干预机

制的研究[D].山东大学，2020.

[10]DUPONT A, SOUKASEUM C, CHEPTOU M, et

al. Relevance of platelet desialylation and thrombocytopenia

in type 2B von Willebrand disease: preclinical and clinical

evidence[J]. Haematologica, 2019, 104(12): 2493-2500.


Refbacks

  • 当前没有refback。