凝血级联活化与大气颗粒物引发心血管疾病关联的研究进展

大量流行病学和毒理学研究证明，大气颗粒物（PM）暴露与心血管疾病发病密切相关，但具体的生物学机制尚不清楚.目前推测可能与吸入体内的PM促进血液凝结有关，血液凝结是心血管疾病发展的重要机制，与多种血栓性疾病相关.该文关注凝血级联活化在PM促凝效应中的关键作用，主要综述了目前PM暴露后外源性和内源性凝血级联通路活化的研究进展.结果表明:①PM暴露能促进凝血级联活化，进而诱导纤维蛋白网形成、纤维蛋白溶解抑制和血小板活化等凝血效应.②PM暴露对外源性通路的影响主要表现为组织因子（tissue factor，TF）的表达增加.③PM可通过表面接触激活因子Ⅻ（FⅫ），进而诱导凝血酶的生成，激活内源性凝血级联通路.研究显示，凝血级联活化是大气颗粒物引发心血管疾病的重要机制之一. 

Research Advances on Relationship between Activation of Coagulation Cascade and Atmospheric Particulate Matter-Induced Cardiovascular Disease

A large number of epidemiological and toxicological studies have proved that atmospheric particulate matter (PM) exposure is closely related to the prevalence of cardiovascular disease, but the specific biological mechanism is still unclear. It is currently speculated that it may be related to blood coagulation caused by inhaled PM. Blood coagulation is an important mechanism for the development of cardiovascular diseases and is associated with a variety of thrombotic diseases. This article focuses on the key role of coagulation cascade activation in the procoagulant effect of PM, and mainly reviews the current research progress on the activation of extrinsic and intrinsic coagulation cascade pathways after exposure to PM. The results show that: (1) Exposure to PM can activate the coagulation cascade, which in turn induces coagulation effects such as blood clots formation, fibrinolysis inhibition and platelet activation. (2) The impact of PM exposure on extrinsic pathways is mainly manifested as increased expression of tissue factor (TF). (3) FⅫ can be activated by contact with the surface of PM, then induce a large amount of thrombin generation and activate the intrinsic coagulation cascade. Studies have shown that the activation of the coagulation cascade is one of the important mechanisms for PM induced cardiovascular disease.