Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA.
Semin Thromb Hemost. 2010 Apr;36(3):286-300. doi: 10.1055/s-0030-1253451. Epub 2010 May 20.
The endothelium is recognized today as a functional and dynamic component of the body that plays an important part in health and disease. This article briefly reviews the role of endothelium in thrombosis and hemostasis. There is a paradigm shift from one that regards the endothelium as one single entity to the concept that the endothelium is heterogeneous. Thrombotic complications in many disorders show a predilection to specific locations, despite the fact that a hypercoagulable state affects the entire body. Likewise, bleeding is more commonly encountered in certain anatomical locations than in others. Recent observations of the heterogeneous distribution of coagulation and fibrinolytic factors in the endothelium and the adaptation of the endothelium to various stimuli may provide an explanation for the diverse phenotypes. Recognition of this changing paradigm is helpful to for the diagnosis and management of bleeding and thrombotic complications. It also helps in the understanding of the pathogenesis of many bleeding and thrombotic disorders, and in the development of new drug designs for site-specific therapy.
内皮细胞如今被认为是机体的一个具有重要功能的活跃组成部分，在健康和疾病中发挥着重要作用。本文简要回顾了内皮细胞在血栓形成和止血中的作用。目前存在一种观念转变，即从将内皮细胞视为单一实体转变为认为内皮细胞是异质的。尽管全身性高凝状态影响整个机体，但许多疾病中的血栓并发症仍表现出对特定部位的偏好。同样，出血更常见于某些解剖部位而非其他部位。最近观察到，凝血和纤维蛋白溶解因子在内皮细胞中的异质分布以及内皮细胞对各种刺激的适应性，可能为不同表型提供了解释。认识到这种变化的范例有助于诊断和管理出血和血栓并发症。它还有助于理解许多出血和血栓性疾病的发病机制，并有助于开发针对特定部位的新型药物设计。
