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Clinics in haematology最新文献

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Thrombosis and immune disorders. 血栓和免疫紊乱。
Pub Date : 1986-05-01
J Vermylen, D Blockmans, B Spitz, H Deckmyn

The purpose of this review has been to draw the attention of clinicians towards the possibility that some of the patients they are treating for thrombosis may have an underlying immune disturbance. This could involve functional abnormalities of the complement system (as in acquired angioneurotic oedema or in paroxysmal nocturnal haemoglobinuria), or cell-mediated immunological damage to the vessel wall (as in Behcet's syndrome or Buerger's disease), or the presence of circulating antibodies (the lupus anticoagulant or antibodies to heparin). While obviously our knowledge on most aspects is still very incomplete, the awareness of the association of thrombosis with certain immune disorders should encourage further detailed studies of mechanisms and enhance our understanding of the role of blood constituents and the vessel wall in thrombogenesis.

这篇综述的目的是引起临床医生的注意,他们正在治疗的一些血栓患者可能存在潜在的免疫障碍。这可能包括补体系统的功能异常(如获得性血管神经性水肿或阵发性夜间血红蛋白尿),或细胞介导的血管壁免疫损伤(如Behcet综合征或Buerger病),或循环抗体(狼疮抗凝血剂或肝素抗体)的存在。虽然我们在大多数方面的知识显然还很不完整,但对血栓形成与某些免疫疾病的关联的认识应该鼓励对机制的进一步详细研究,并增强我们对血液成分和血管壁在血栓形成中的作用的理解。
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引用次数: 0
1 Arachidonate Metabolism in Blood Cells and the Vessel Wall 花生四烯酸在血细胞和血管壁中的代谢
Pub Date : 1986-05-01 DOI: 10.1016/S0308-2261(18)30018-3
S. Moncada, E.A. Higgs
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引用次数: 0
9 Diabetes Mellitus, Vascular Disease and Thrombosis 糖尿病、血管疾病和血栓形成
Pub Date : 1986-05-01 DOI: 10.1016/S0308-2261(18)30026-2
Jan Dirk Banga, Jan J. Sixma
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引用次数: 0
Fibrinogen, fibrin and fibrin degradation products in relation to atherosclerosis. 纤维蛋白原、纤维蛋白和纤维蛋白降解产物与动脉粥样硬化的关系。
Pub Date : 1986-05-01
E B Smith

Many human atherosclerotic lesions, showing no evidence of fissure or ulceration, contain a large amount of fibrin which may be in the form of mural thrombus on the intact surface of the plaque, in layers within the fibrous cap, in the lipid-rich centre, or diffusely distributed throughout the plaque. Small mural thrombi are invaded by SMCs and collagen is deposited in patterns closely resembling the early proliferative gelatinous lesions. In experimental animals, thrombi are converted into lesions with all the characteristics of fibrous plaques, and in saphenous-vein bypass grafts, fibrin deposition is the main cause of wall thickening and occlusion. There seems little doubt that fibrin deposition can both initiate atherogenesis and contribute to the growth of plaques. Epidemiological studies indicate that increased levels of fibrinogen and clotting activity are associated with accelerated atherosclerosis, and although blood fibrinolytic activity has given inconsistent results, in arterial intima both fibrinolytic activity and plasminogen concentration are decreased in cardiovascular disease. Fibrin may stimulate cell proliferation by providing a scaffold along which cells migrate, and by binding fibronectin, which stimulates cell migration and adhesion. Fibrin degradation products, which are present in the intima, may stimulate mitogenesis and collagen synthesis, attract leukocytes, and alter endothelial permeability and vascular tone. In the advanced plaque fibrin may be involved in the tight binding of LDL and accumulation of lipid. Thus there is extensive evidence that enhanced blood coagulation is a risk factor not only for thrombotic occlusion, but also for atherogenesis. Enhanced blood coagulation frequently coexists with hyperlipidaemia and, together, these may have a synergistic effect on atherogenesis.

许多人类动脉粥样硬化病变,没有裂缝或溃疡的迹象,含有大量的纤维蛋白,其可能以附壁血栓的形式出现在斑块的完整表面,在纤维帽内分层,在富含脂质的中心,或弥漫性分布在整个斑块。小的壁血栓被SMCs侵入,胶原沉积的模式与早期增殖性胶质病变非常相似。在实验动物中,血栓转化为具有纤维斑块所有特征的病变,而在隐静脉旁路移植术中,纤维蛋白沉积是导致血管壁增厚和闭塞的主要原因。毫无疑问,纤维蛋白沉积既可以引发动脉粥样硬化,又可以促进斑块的生长。流行病学研究表明,纤维蛋白原水平和凝血活性的升高与动脉粥样硬化的加速有关,尽管血液纤维蛋白溶解活性给出了不一致的结果,但在动脉内膜中,心血管疾病患者的纤维蛋白溶解活性和纤溶酶原浓度均下降。纤维蛋白可以通过提供细胞迁移的支架和结合纤维连接蛋白来刺激细胞迁移和粘附,从而刺激细胞增殖。存在于内膜的纤维蛋白降解产物可能刺激有丝分裂和胶原合成,吸引白细胞,并改变内皮通透性和血管张力。在斑块晚期,纤维蛋白可能参与LDL的紧密结合和脂质积累。因此,有大量证据表明,凝血增强不仅是血栓闭塞的危险因素,也是动脉粥样硬化的危险因素。凝血功能增强经常与高脂血症共存,两者可能对动脉粥样硬化有协同作用。
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引用次数: 0
Diabetes mellitus, vascular disease and thrombosis. 糖尿病、血管疾病和血栓形成。
Pub Date : 1986-05-01
J D Banga, J J Sixma
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引用次数: 0
Thrombosis and the vessel wall. 血栓和血管壁。
Pub Date : 1986-05-01
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引用次数: 0
Platelet and vessel wall interaction and the genesis of atherosclerosis. 血小板与血管壁的相互作用及动脉粥样硬化的发生。
Pub Date : 1986-05-01
C N Chesterman, M C Berndt

On the basis of in vitro studies, biochemistry and cell biology the interactions between platelets, other circulating blood cells and the vessel wall are complex and wide-ranging. In essence, the effects of platelets adhering to injured luminal surface might include: Aggregation and adherence of further platelets; Activation of coagulation and fibrin formation; Displacement of AT-III from endothelial surface; Recruitment and activation of potentially injurious polymorphonuclear leukocytes and monocytes; Recruitment and proliferation of smooth muscles cells from the vessel media to the intima; Vasoconstriction; Initiation of feedback mechanisms such as PGI2 release to limit the process. These effects are capable of contributing to the initial lesions and the progression of the atherosclerosis. As the lesions become more complex, and particularly as the normal endothelium is lost, there is morphological evidence that there is deposition of thrombus (for discussion see Chapter 4) and 111In-labelled platelet imaging experiments in patients document platelet uptake onto atherosclerotic plaques (Davis et al, 1978).

在体外研究、生物化学和细胞生物学的基础上,血小板和其他循环血细胞与血管壁之间的相互作用是复杂而广泛的。从本质上讲,血小板粘附在损伤的管腔表面的作用可能包括:进一步的血小板聚集和粘附;凝血和纤维蛋白形成的激活;AT-III在内皮表面的位移;潜在有害的多形核白细胞和单核细胞的募集和激活;平滑肌细胞从血管介质向内膜的募集和增殖;血管收缩;启动反馈机制,如PGI2发布,以限制流程。这些作用能够促进初始病变和动脉粥样硬化的进展。随着病变变得更加复杂,特别是正常内皮的丧失,形态学证据表明存在血栓沉积(详见第4章),111in标记的患者血小板成像实验记录血小板摄取到动脉粥样硬化斑块上(Davis et al, 1978)。
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引用次数: 0
Clinical studies of autografting in acute lymphocytic leukaemia 自体移植治疗急性淋巴细胞白血病的临床研究
Pub Date : 1986-02-01 DOI: 10.1016/S0308-2261(86)80007-8
Karel A. Dicke, Gary Spitzer

The role of autologous marrow transplantation has been reviewed in this chapter. The transplantation results in first remission are difficult to interpret due to the prognostically heterogeneous patient population transplanted and the ever-changing natural history of first complete remission due to more aggressive conventional-dose chemotherapy regimen. The biological role of marrow purging, i.e. elimination of leukaemic cells from the graft, is yet unclear. It is the opinion of the authors that studies in second and subsequent remission can resolve burning issues such as the efficacy of various high-dose conditioning regimens and of different methods of elimination of leukaemic cells such as procedures based on immunological methods, monoclonal antibodies and on differences in sensitivity of stem cells and leukaemic cells to in vitro chemotherapy. It may well be that a large number of patients is needed and, therefore, a multi-centre study is indicated.

本章综述了自体骨髓移植的作用。由于移植的患者群体预后不均匀,以及由于更积极的常规剂量化疗方案,首次完全缓解的自然历史不断变化,因此很难解释移植的首次缓解结果。骨髓清除(即从移植物中清除白血病细胞)的生物学作用尚不清楚。作者认为,对第二次和随后的缓解的研究可以解决诸如各种高剂量调理方案和消除白血病细胞的不同方法(如基于免疫方法、单克隆抗体和干细胞和白血病细胞对体外化疗敏感性差异的程序)的功效等紧迫问题。很可能需要大量患者,因此需要进行多中心研究。
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引用次数: 25
Clinical studies of ABMT in non-Hodgkin's lymphoma ABMT在非霍奇金淋巴瘤中的临床研究
Pub Date : 1986-02-01 DOI: 10.1016/S0308-2261(86)80008-X
C.R.J. Singer, A.H. Goldstone
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引用次数: 46
The use of monoclonal antibodies for purging autologous bone marrow in the lymphoid malignancies 单克隆抗体在淋巴细胞恶性肿瘤自体骨髓清除中的应用
Pub Date : 1986-02-01 DOI: 10.1016/S0308-2261(86)80015-7
Elizabeth A. Macintyre
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引用次数: 23
期刊
Clinics in haematology
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