Studennikova V V, Severgina L O, Sinyavin G V, Rapoport L M, Korovin I A
Sechenov First Moscow State Medical University, Ministry of Health of the Russia, Moscow, Russia.
Khirurgiia (Mosk). 2019(10):69-74. doi: 10.17116/hirurgia201910169.
Varicose veins of lower extremities, varicocele and varicose dilation of pelvic veins including ovaricovaricocele are the most common non-inflammatory diseases of venous system. The same mechanisms determined varicose dilatation regardless localization of the vein. First of all, these are wall weakness and valvular insufficiency combined with hereditary collagen fiber defectiveness in case of undifferentiated connective tissue syndrome. Imbalance between different types of collagen in vascular wall (especially types I and III) also results wall weakness. Other important mechanisms are smooth muscle cells dysfunction followed by excessive intracellular synthesis and intramuscular fibrosis and imbalance of protease system due to overproduction of metalloproteinases. We consider that different forms of varicose veins (varicose veins of lower extremities, varicocele, ovaricovaricocele) may be unified within one pathology (varicose vein disease).
下肢静脉曲张、精索静脉曲张以及包括卵巢静脉曲张在内的盆腔静脉曲张扩张是静脉系统最常见的非炎性疾病。无论静脉位于何处,相同的机制决定了静脉曲张扩张。首先,这些机制包括管壁薄弱和瓣膜功能不全,在未分化结缔组织综合征的情况下还伴有遗传性胶原纤维缺陷。血管壁中不同类型胶原蛋白(尤其是I型和III型)之间的失衡也会导致管壁薄弱。其他重要机制包括平滑肌细胞功能障碍,随后是细胞内过度合成和肌内纤维化,以及由于金属蛋白酶过度产生导致的蛋白酶系统失衡。我们认为,不同形式的静脉曲张(下肢静脉曲张、精索静脉曲张、卵巢静脉曲张)可能统一于一种病理状态(静脉曲张疾病)。