抗凝治疗抑制肝纤维化进程的研究进展

夏翊夫; 张春清

doi:10.3969/j.issn.1001-5256.2018.10.036

抗凝治疗抑制肝纤维化进程的研究进展

DOI: 10.3969/j.issn.1001-5256.2018.10.036

山东大学附属省立医院消化内科

基金项目:

国家自然科学基金资助项目(81770606)；

详细信息

中图分类号: R575.2
计量
- 文章访问数: 2068
- HTML全文浏览量: 39
- PDF下载量: 429
- 被引次数: 0
出版历程
- 收稿日期: 2018-06-25
- 出版日期: 2018-10-20

Research advances in anticoagulant therapy for liver fibrosis

Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong University

Research funding:

摘要

摘要: 肝纤维化是慢性肝病发展为肝硬化的病理过程,是在肝细胞广泛坏死基础上产生肝脏纤维组织弥漫性增生,导致肝小叶正常结构和血液供应遭到影响。在此过程中,血小板在肝窦内聚集并形成微血栓可能促进肝纤维化进展。简述了血小板与肝纤维化的关系,回顾抗凝治疗改善肝功能和肝纤维化评分的新进展。抗凝治疗的分子机制还有待研究,探索安全有效的抗凝药物可能为肝纤维化治疗开辟新途径。
- 肝硬化 /
- 血栓形成 /
- 抗凝药 /
- 综述
Abstract: Liver fibrosis is a pathological process in which chronic liver disease develops into liver cirrhosis. It is caused by diffuse proliferation of liver fibrous tissue on the basis of extensive necrosis of liver cells, resulting in destruction of the normal structure and blood supply of liver lobules. In the process of liver fibrosis, platelets aggregate in the sinusoids to form microthrombi, which may promote liver fibrosis.This article briefly describes the relationship between platelets and liver fibrosis and reviews the latest advances in anticoagulant therapy for improving liver function and liver fibrosis score. The molecular mechanism of anticoagulant therapy remains to be studied, and safe and effective anticoagulants may provide a new approach for the treatment of liver fibrosis.
- liver cirrhosis /
- thrombosis /
- anticoagulants /
- review

HTML全文

参考文献(18)

[1]QAMAR A, VADUGANATHAN M, GREENBERGER NJ, et al.Oral anticoagulation in patients with liver disease[J].J Am Coll Cardiol, 2018, 71 (19) :2162-2175.

[2]LESURTEL M, GRAF R, ALEIL B, et al.Platelet-derived serotonin mediates liver regeneration[J].Science, 2006, 312 (5770) :104-107.

[3]ARMANDO T.Hemostasis abnormalities in cirrhosis[J].Curr Opin Hematol, 2015, 22 (5) :406-412.

[4]LI JT, ZHANG ML.Clinical analysis of 2 cases of liver cirrhosis complicated with venous thrombosis of lower extremity[J].Chin JMed Offic, 2018, 46 (3) :376. (in Chinese) 李军婷, 张美琳.肝硬化并下肢静脉血栓形成2例临床分析[J].临床军医杂志, 2018, 46 (3) :376.

[5]PECK-RADOSACLIEVIC M.Thrombocytopenia in liver disease[J].Can J Gastroenterol, 2000, 14 (Suppl D) :60D-66D.

[6]KAJIHARA M, OKAZAKI Y, KATO S, et al.Evaluation of platelet kinetics in patients with liver cirrhosis:Similarity to idiopathic thrombocytopenic purpura[J].J Gastroenterol Hepatol, 2007, 22:112-118.

[7]MEYER J, LEJMI E, FONTANA P, et al.A focus on the role of platelets in liver regeneration:Do platelet-endothelial cell interactions initiate the regenerative process?[J].J Hepatol, 2015, 63 (5) :1263-1271.

[8]MATTHEW M, YASUKO I.Biology of portal hypertension[J].Hepatol Int, 2018, 12 (Suppl 1) :11-23.

[9]REIICHIRO K, HIROHISA Y, OSAMU N, et al.Accumulation of platelets in the liver may be an important contributory factor to thrombocytopenia and liver fibrosis in chronic hepatitis C[J].JGastroenterol, 2013, 48 (4) :526-534.

[10]YOSHIDA S, IKENAGA N, LIU SB, et al.Extrahepatic plateletderived growth factor-β, delivered by platelets, promotes activation of hepatic stellate cells and biliary fibrosis in mice[J].Gastroenterology, 2014, 147 (6) :1378-1392.

[11]KARL E, AUDREY D, EIMEAR D, et al.Increased soluble GPVIlevels in cirrhosis:Evidence for early in vivo platelet activation[J].J Thromb Thrombolysis, 2017, 43 (1) :54-59.

[12]QUENTIN M, ANSTEE, AMEET D, et al.The role of hypercoagulability in liver fibrogenesis[J].Clin Res Hepatol Gastroenterol, 2011, 35 (8-9) :526-533.

[13]TRIPODI A, PRIMIGNANI M, MANNUCCI PM, et al.Changing concepts of cirrhotic coagulopathy[J].Am J Gastroenterol, 2017, 112 (2) :274-281.

[14]BINTA S, GAURANG S.AntifIbrotic effect of heparin on liver fbrosis model in rats[J].World J Gastrointest Pharmacol Ther, 2012, 3 (6) :86-92.

[15]LI CJ, YANG ZH, SHI XL, et al.Effects of aspirin and enoxaparin in a rat model of liver fibrosis[J].World J Gastroenterol, 2017, 23 (35) :6412-6419.

[16]JIANG ZG, FELDBRUGGE L, TAPPER EB, et al.Aspirin use is associated with lower indices of liver fibrosis among adults in the U-nited States[J].Aliment Pharmacol Ther, 2016, 43 (6) :734-743.

[17]AMELLE PR, PIERRE-YVES B, FILOMENA C, et al.Aspirin may reduce liver fibrosis progression:Evidence from a multicenter retrospective study of recurrent hepatitis C after liver transplantation[J].Clin Res Hepatol Gastroenterol, 2014, 38 (5) :570-576.

[18]SUN YP, GUO XX.Clinical effect of probiotics in treatment of liver cirrhosis:A Meta-analysis[J].J Clin Hepatol, 2018, 34 (1) :73-79. (in Chinese) 孙元培, 郭晓霞.微生态制剂治疗肝硬化的Meta分析[J].临床肝胆病杂志, 2018, 34 (1) :73-79.

施引文献

资源附件(0)

访问统计