胶原和弹性纤维与曲张静脉管壁重塑

摘要

曲张静脉管壁胶原和弹性纤维的病理改变,一直是静脉外科发展中存在着争议的问题.在此从正常下肢静脉胶原和弹性纤维的结构与功能、曲张静脉管壁胶原和弹性纤维的分布与含量及影响静脉管壁胶原和弹性纤维改变的因素进行综述.认为静脉压增高和缺氧是静脉管壁平滑肌细胞和细胞外基质发生变化的启动因素.曲张静脉管壁胶原和弹性纤维的病理改变受其血管平滑肌细胞、基质金属蛋白酶、氧自由基、Fas基因等诸因素影响.%The pathogenesis of collagen and elastic fiber alteration in varicose vein has been always controversial throughout the development of venous surgery.This article reviews the structure and function of collagen and elastic fibers in normal lower limb vein, their distribution and content in varicose vein wall, and contributing factors of their changes in venous wall.Increased venous pressure and hypoxia are thought to initiate the alteration in venous wall smooth muscle cells and extracellular matrix.The pathogenesis of collagen and elastic fiber alteration in varicose vein results from vascular smooth muscle cells,matrix metalloproteinases, oxygen radicals, and Fas gene.