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腹主动脉瘤的病理生理学:生物标志物与新型治疗靶点

Pathophisiology of abdominal aortic aneurysm: biomarkers and novel therapeutic targets.

作者信息

Torres-Fonseca Monica, Galan María, Martinez-Lopez Diego, Cañes Laia, Roldan-Montero Raquel, Alonso Judit, Reyero-Postigo Teresa, Orriols Mar, Mendez-Barbero Nerea, Sirvent Marc, Blanco-Colio Luis Miguel, Martínez José, Martin-Ventura Jose Luis, Rodríguez Cristina

机构信息

Vascular Research Lab, Instituto de Investigación Sanitaria, Hospital Universitario Fundación Jiménez Díaz (IIS-FJD, UAM), Madrid, España; CIBER de Enfermedades Cardiovasculares (CIBERCV), España.

CIBER de Enfermedades Cardiovasculares (CIBERCV), España; Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, IIB-Sant Pau, Barcelona, España.

出版信息

Clin Investig Arterioscler. 2019 Jul-Aug;31(4):166-177. doi: 10.1016/j.arteri.2018.10.002. Epub 2018 Dec 7.

Abstract

Abdominal aortic aneurysm (AAA) is a vascular pathology with a high rate of morbidity and mortality and a prevalence that, in men over 65 years, can reach around 8%. In this disease, usually asymptomatic, there is a progressive dilatation of the vascular wall that can lead to its rupture, a fatal phenomenon in more than 80% of cases. The treatment of patients with asymptomatic aneurysms is limited to periodic monitoring with imaging tests, control of cardiovascular risk factors and treatment with statins and antiplatelet therapy. There is no effective pharmacological treatment capable of limiting AAA progression or avoiding their rupture. At present, the aortic diameter is the only marker of risk of rupture and determines the need for surgical repair when it reaches values greater than 5.5cm. This review addresses the main aspects related to epidemiology, risk factors, diagnosis and clinical management of AAA, exposes the difficulties to have good biomarkers of this pathology and describes the strategies for the identification of new therapeutic targets and biomarkers in AAA.

摘要

腹主动脉瘤(AAA)是一种发病率和死亡率较高的血管疾病,在65岁以上男性中的患病率可达8%左右。在这种通常无症状的疾病中,血管壁会逐渐扩张,可能导致破裂,超过80%的病例会出现致命现象。无症状动脉瘤患者的治疗仅限于通过影像学检查进行定期监测、控制心血管危险因素以及使用他汀类药物和抗血小板治疗。目前尚无能够限制AAA进展或避免其破裂的有效药物治疗方法。目前,主动脉直径是唯一的破裂风险标志物,当其达到大于5.5厘米的值时,决定是否需要进行手术修复。本综述探讨了与AAA的流行病学、危险因素、诊断和临床管理相关的主要方面,揭示了获得该疾病良好生物标志物的困难,并描述了在AAA中识别新治疗靶点和生物标志物的策略。

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