Franchini Massimo, Zaffanello Marco, Veneri Dino
Servizio di Immunoematologia e Trasfusione, Ospedale Policlinico, Piazzale L. Scuro Azienda Ospedaliera di Verona, Italy.
Thromb Res. 2006;118(2):177-84. doi: 10.1016/j.thromres.2005.07.013. Epub 2005 Aug 29.
The thrombotic microangiopathies are microvascular occlusive disorders characterized by hemolytic anemia caused by fragmentation of erythrocytes and thrombocytopenia due to increased platelet aggregation and thrombus formation, eventually leading to disturbed microcirculation with reduced organ perfusion. Depending on whether brain or renal lesions prevail, two different entities have been described: thrombotic thrombocytopenic purpura (TTP) and hemolytic uremic syndrome (HUS). However, not rarely the clinical distinctions between these two conditions remain questionable. Recent studies have contributed greatly to our current understanding of the molecular mechanisms leading to TTP and HUS. In this review, we briefly focus on the most important advances in the pathophysiology, diagnosis and treatment of these two thrombotic microangiopathies.
血栓性微血管病是微血管闭塞性疾病,其特征是红细胞破碎导致溶血性贫血,以及血小板聚集增加和血栓形成导致血小板减少,最终导致微循环紊乱和器官灌注减少。根据脑部或肾脏病变是否占主导地位,已描述了两种不同的类型:血栓性血小板减少性紫癜(TTP)和溶血尿毒综合征(HUS)。然而,这两种情况之间的临床区别往往仍存在疑问。最近的研究对我们目前对导致TTP和HUS的分子机制的理解有很大贡献。在这篇综述中,我们简要关注这两种血栓性微血管病在病理生理学、诊断和治疗方面的最重要进展。