Rehm J P, Grange J J, Baxter B T
Department of Surgery, University of Nebraska Medical Center, Omaha 68198-3280, USA.
Semin Vasc Surg. 1998 Sep;11(3):193-202.
Arterial aneurysms account for a significant proportion of the various diseases treated by the vascular surgeon. Refinements of surgical technique have reduced the morbidity and mortality, yet, we have no effective medical therapy to prevent the growth of small aneurysms. Although the pathogenesis of aneurysmal disease has received attention, the complex nature of the process has not been fully elucidated. The emergence of new and refined techniques in the fields of immunology, biochemistry, cell biology, and genetics has advanced the understanding of the dynamic interactions within a diseased vessel. Although past work was descriptive, investigators are now studying the role of the local inflammatory infiltrates and the destructive proteolytic enzymes they produce and regulate. The clinical observations we make regarding the familial tendency of abdominal aortic aneurysms (AAA) underscores the importance of research directed at identifying an aneurysm-related gene. As new pieces are added to the puzzle and the picture of AAA pathogenesis becomes more clear, we can expect the development of new therapeutic measures directed at controlling the critical matrix changes, and thus the growth of small AAA, as well as screening methods searching for AAA-associated genes.
动脉瘤在血管外科医生治疗的各类疾病中占相当大的比例。手术技术的改进降低了发病率和死亡率，然而，我们尚无有效的药物疗法来预防小动脉瘤的生长。尽管动脉瘤疾病的发病机制已受到关注，但该过程的复杂性尚未完全阐明。免疫学、生物化学、细胞生物学和遗传学领域新的精细技术的出现，加深了我们对病变血管内动态相互作用的理解。尽管过去的研究多为描述性的，但现在研究人员正在研究局部炎性浸润及其产生和调节的破坏性蛋白水解酶的作用。我们对腹主动脉瘤（AAA）家族倾向的临床观察强调了旨在鉴定与动脉瘤相关基因的研究的重要性。随着拼图上新的板块不断增加，AAA发病机制的图景越来越清晰，我们有望开发出针对控制关键基质变化从而控制小AAA生长的新治疗措施，以及寻找与AAA相关基因的筛查方法。
