髋关节置换缺血性脑卒中粒细胞胞外陷阱的作用

Role of neutrophil extracellular trap in ischemic stroke after hip arthroplasty

摘要:

缺血性脑卒中是髋关节置换术后少见且严重的并发症之一，其致残率高，严重时危及生命，发病过程与创伤性炎症反应、血栓形成等密切相关。近十年研究发现，中性粒细胞胞外陷阱（neutrophil extracellular traps, NETs）参与动脉血栓形成。 髋关节置换术后机体的炎症反应、血小板的活化等激活中性粒细胞，诱导 NETs 产生并释放，使血液处于高凝状态、血小板高效聚集、促进凝血酶产生、激活部分凝血因子、降低动脉粥样硬化斑块的稳定性，导致术后缺血性脑卒中发生。NETs 相关生物标志物的检测可预测术后缺血性脑卒中发生，抑制 NETs 产生或促进 NETs 降解为术后缺血性脑卒中预防及治疗提供新的方向，为研发新的药物提供新的思路。

Abstract:

Ischemic stroke is one of the rare, but serious complications after hip arthroplasty. It has a high disability rate, and is lifethreatening in severe cases. Its pathogenesis is closely related to traumatic inflammation and thrombosis. Recent studies have found that neutrophil extracellular traps (NETs) are involved in the formation of arterial thrombosis. After hip arthroplasty, neutrophils are activated by inflammation and platelet activation, inducing the production and release of NETs, keeping blood in a hypercoagulable state, efficiently aggregating platelets, promoting thrombin production, activating part of coagulation factors, and reducing the stability of atherosclerotic plaques, leading to ischemic stroke after surgery. The detection of NETs related biomarkers can predict the occurrence of postoperative ischemic stroke, inhibit the production or promote the degradation of NETs, and provide a new direction for the prevention and treatment of postoperative ischemic stroke, and provide a new idea for the development of new drugs.