血管平滑肌细胞在胸主动脉瘤及夹层发生发展中的作用

中图分类号：R543 文献标志码：A 文章编号：1001-5779（2025）05-0429-05

DOI：10.3969/j.issn. 1001-5779.2025.05.003

Abstract：Thoracicaorticaneurysmand dissectionsrepresent agroupof clinicallprevalentcardiovasculardisorders characterizedbyprogressivedilationof theaorticwall.Itspathogenesisremainsincompletelyunderstood.Anatomicaly， the aorticwallconsistsof threelayers，with vascularsmooth musclecelsbeing the principal constituentof the midle layer.Thisreviewsynthesizesrecent domesticand internationalliterature toexaminethemechanisticcontributionsof vascularsmooth muscle cels toaortic wallpathologyand dissection development，while evaluating targeted preventive andtherapeutic strategies directedat thesecells.The findingsdemonstrate thatthoracicaorticaneurysmand dissection pathogenesis induces phenotypic switching of vascular smooth musclecells into functionally diversesubtypes.These transformedcells exhibit dual functionality：theyrespond to neural stimuli bysecreting growth factorsand cytokines including MMP，TGF- β and TNF- α that modulate disease progression，while simultaneously releasing collagen to facilitate aorticremodeling and repair.Therapeutic interventions for thoracic aortic aneurysmsand dissections must prioritize inhibitionofkey genetic regulators governing vascularsmooth musclecellphenotypic transition，particularlyupstreamand downstream mediatorssuchas MEKK2/3，ALDH2 and ANXA1.

KeyWords：Thoracicaorticaneurysms；Thoracicaortic dissections；Vascular smooth musclecells；Pathogenesis； Targeted therapy

胸主动脉瘤是一种极其危险的心血管疾病，由于各种因素导致的主动脉壁中层强度进行性减弱，进而逐渐扩张，当扩张到一定程度后主动脉内膜被血流撕裂形成破口，血流进入破口，剥离主动脉壁内血管结构，在主动脉内膜与中外膜之间形成假腔，称为主动脉夹层。（剩余10887字）