Фенотип тромбоцитов и инфаркт миокарда
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1 - ФГБУ «Российский кардиологический научно-производственный комплекс» Министерства здравоохранения РФ; ул. 3-я Черепковская, 15А, Москва, 121552, Российская Федерация; 2 - ГБОУ ВПО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Министерства
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Тип статьи: ФУНДАМЕНТАЛЬНАЯ КАРДИОЛОГИЯ
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Аннотация
Закрытие коронарных артерий вследствие образования окклюзирующего тромба является основной причиной развития острого инфаркта миокарда. Основными компонентами образующегося тромба являются нити фибрина и клетки крови. Установлено, что в начальный период образования тромба его основными клеточными компонентами являются активированные тромбоциты, которые быстро стабилизируются волокнами фибрина со снижением удельной доли тромбоцитов в тромбе с течением времени. Формирование окклюзирующих тромбов сильно зависит от адгезивных свойств тромбоцитов и их быстрой реакции на стимулы, возникающие в пораженной сосудистой стенке. Этот обзор освещает роль мембранного фенотипа тромбоцитов в патофизиологии инфаркта миокарда. При описании фенотипа тромбоцитов мы остановились на количественных и качественных характеристиках поверхностного белкового состава мембран, наиболее важных для участия тромбоцитов в процессах свертывания крови, воспалительных реакциях и процессах заживления тканей после повреждения. Среди этих белков можно выделить гликопротеиновые рецепторы и интегрины (гликопротеин Ib, гликопротеин VI, интегрин αIIbβ3 и т. д.), прокоагулянтные белки (анионные фосфолипиды, факторы свертывания), молекулы клеточной адгезии (фибриноген, фактор Виллебранда, селектины и т. д.), хемокины (SDF-1) и некоторые мембранно-связанные провоспалительные белки (мСРБ). В заключение мы представим несколько новых клинических исследований, в которых рассматривается прогностическая ценность некоторых мембранно-связанных белков при острых коронарных синдромах для выявления пациентов с высоким риском развития коронарных событий.Литература
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