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血栓形成:诊断与治疗的新型纳米医学概念

Thrombosis: Novel nanomedical concepts of diagnosis and treatment.

作者信息

Cicha Iwona

机构信息

Iwona Cicha, Cardiovascular Nanomedicine Unit, Section of Experimental Oncology and Nanomedicine, ENT-Department, University Hospital Erlangen, 91054 Erlangen, Germany.

出版信息

World J Cardiol. 2015 Aug 26;7(8):434-41. doi: 10.4330/wjc.v7.i8.434.

Abstract

Intravascular thrombosis, a critical pathophysiological feature of many cardiovascular disorders, leads to the formation of life-threatening obstructive blood clots within the vessels. Rapid recanalization of occluded vessels is essential for the patients' outcome, but the currently available systemic fibrinolytic therapy is associated with low efficacy and tremendous side effects. Additionally, many patients are ineligible for systemic thrombolytic therapy, either due to delayed admission to the hospital after symptom onset, or because of recent surgery, or bleeding. In order to improve the treatment efficacy and to limit the risk of hemorrhagic complications, both precise imaging of the affected vascular regions, and the localized application of fibrinolytic agents, are required. Recent years have brought about considerable advances in nanomedical approaches to thrombosis. Although these thrombus-targeting imaging agents and nanotherapies are not yet implemented in humans, substantial amount of successful in vivo applications have been reported, including animal models of stroke, acute arterial thrombosis, and pulmonary embolism. It is evident that the future progress in diagnosis and treatment of thrombosis will be closely bound with the development of novel nanotechnology-based strategies. This Editorial focuses on the recently reported approaches, which hold a great promise for personalized, disease-targeted treatment and reduced side effects in the patients suffering from this life-threatening condition.

摘要

血管内血栓形成是许多心血管疾病的关键病理生理特征,会导致在血管内形成危及生命的阻塞性血凝块。闭塞血管的快速再通对患者的预后至关重要,但目前可用的全身纤溶治疗疗效低且副作用巨大。此外,许多患者由于症状发作后入院延迟、近期手术或出血等原因而不符合全身溶栓治疗的条件。为了提高治疗效果并限制出血并发症的风险,既需要对受影响的血管区域进行精确成像,也需要局部应用纤溶药物。近年来,纳米医学治疗血栓的方法取得了相当大的进展。尽管这些血栓靶向成像剂和纳米疗法尚未应用于人体,但已有大量成功的体内应用报道,包括中风、急性动脉血栓形成和肺栓塞的动物模型。显然,血栓形成诊断和治疗的未来进展将与基于新型纳米技术的策略的发展密切相关。本社论重点关注最近报道的方法,这些方法有望为患有这种危及生命疾病的患者提供个性化、疾病靶向治疗并减少副作用。

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