Flow effects on coagulation and thrombosis
Flow effects on coagulation and thrombosis
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DOI：
10.1161/01.atv.0000229658.76797.30
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发表时间：
2006-08-01
影响因子：
8.7
通讯作者：
Hathcock, James J.
中科院分区：
文献类型：
--
作者：
Hathcock, James J.
血栓形成发生在动态流变场中，随着血栓生长到闭塞尺寸，动态流变场不断变化。在血栓形成的起始阶段，血管壁附近的流动条件调节反应性组分被递送到损伤部位的速度以及反应产物被散布的速度。尽管可溶性凝血因子向血管的递送和去除被认为是通过经典的对流-扩散现象发生的，但细胞和血小板向损伤壁的移动通过流动依赖性细胞-细胞碰撞而强烈增强，这增强了它们与壁相互作用的能力。此外，增加的剪切条件已被证明激活血小板，改变蛋白质如组织因子（TF）和TF途径抑制剂的细胞定位，并调节基因的产生。在没有高剪切力的情况下，红细胞、白细胞和血小板可以彼此形成稳定的聚集体或与血管壁内衬的细胞形成稳定的聚集体，这除了改变聚集体或血管壁的生化组成之外，还有效地增加了局部血液粘度。因此，血液动力学力不仅调节特定解剖部位对血栓形成的偏好，而且它们强烈影响血栓的生化组成和血栓形成中涉及的反应途径。
Thrombosis occurs in a dynamic theological field that constantly changes as the thrombus grows to occlusive dimensions. In the initiation of thrombosis, flow conditions near the vessel wall regulate how quickly reactive components are delivered to the injured site and how rapidly the reaction products are disseminated. Whereas the delivery and removal of soluble coagulation factors to the vessel is thought to occur via classic convection-diffusion phenomena, the movement of cells and platelets to the injured wall is strongly augmented by flow-dependent cell-cell collisions that enhance their ability to interact with the wall. In addition, increased shear conditions have been shown to activate platelets, alter the cellular localization of proteins such as tissue factor (TF) and TF pathway inhibitor, and regulate gene production. In the absence of high shearing forces, red cells, leukocytes, and platelets can form stable aggregates with each other or cells lining the vessel wall, which, in addition to altering the biochemical makeup of the aggreaate or vessel wall, effectively increases the local blood viscosity. Thus, hemodynamic forces not only regulate the predilection of specific anatomic sites to thrombosis, but they strongly influence the biochemical makeup of thrombi and the reaction pathways involved in thrombus formation.