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摘要: 血栓性疾病是指因血液在血管内异常凝固形成血栓，从而引起一系列临床症状的疾病总称，包括下肢深静脉血栓形成、脑卒中、动脉粥样硬化、糖尿病等疾病。血栓形成是一个复杂的、循序渐进的过程，大致可概括为血管内皮损伤暴露、内源性凝血系统启动、血小板黏附聚集、纤维蛋白网生成、血细胞淤积等过程。在此过程中，巨噬细胞发挥了重要作用。它们通过参与局部的炎症反应，调控血栓的形成和消退。巨噬细胞极化是近年来的研究热点，它主要指巨噬细胞在不同环境刺激下发生形态和功能上的变化。巨噬细胞极化可分为经典型（M1型）、替代型（M2型）以及一些特殊的极化状态。巨噬细胞极化状态的转变在免疫应答、病原体感染、肿瘤免疫和自身免疫等过程中具有重要作用。综述巨噬细胞极化在血栓性疾病中的调控关系，为血栓性疾病的治疗提供新的方向。Abstract: Thrombotic diseases refer to a group of conditions characterized by abnormal blood coagulation within blood vessels, leading to the formation of blood clots and a series of clinical symptoms. This includes diseases such as deep vein thrombosis in the lower extremities, stroke, atherosclerosis, and diabetes. Thrombosis is a complex, progressive process that can be broadly summarized as the exposure of vascular endothelial damage, activation of the intrinsic coagulation system, platelet adhesion and aggregation, fibrin network formation, blood cell stasis. Macrophages play an important role in this process. They are involved in local inflammatory responses, regulating both the formation and resolution of thrombi. Macrophage polarization is a hot research topic in recent years, which mainly refers to the morphological and functional changes of macrophages in response different environmental stimuli. Macrophage polarization can be classified into classical （M1） and alternative （M2） types, as well as several specialized polarization states. The transition of macrophage polarization states plays an important role in immune responses, pathogen infections, tumor immunity, and autoimmune processes. This review discusses the regulatory relationship of macrophage polarization in thrombotic diseases, providing new directions for the treatment of these conditions.
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Key words:
- Thrombotic diseases /
- Deep vein thrombosis /
- Macrophages /
- Macrophage polarization
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图 1 参与巨噬细胞极化部分物质流程图
Figure 1. Flowchart of the involvement of substances in macrophage polarization
表 1 部分疾病巨噬细胞调控及相关通路
Table 1. Regulation of macrophages and rRelated Pathways in certain diseases
疾病 相关通路 巨噬细胞调控 动脉粥样硬化 NF-κB相关通路，
Notch 信号通路，
PI3K/Akt通路，
KLF-4-Ch25h/LXR通路，
STAT相关通路等M1：LPS，IFN- γ，粒细胞－巨噬细胞集落刺激因子（GM-CSF），C反应蛋白CRP，螺旋Ｂ表面肽（HBSP）（*）等 M2: IL-4、10、13，蛋白激酶A（ PKA），高密度脂蛋（ HDL），HBSP，KLF-4等 高血压 STAT相关通路，
TLR4/NF-κB通路等M1：骨桥蛋白（*），缺氧诱导因子-1（HIF-1），血红素加氧酶（ＨＯ）（*） 等 M2：A型清道夫受体（SR-A）、血管紧张素II（AngII）、骨桥蛋白、HO等 糖尿病 JNK通路，
STAT相关通路，
miR-330-5p /Tim-3 通路，
Wnt 信号通路等M1：TNF-α，IL-6 NO，MiR-657，MCP-1，活性维生素D（*） 等
M2: miR-330-5p等肿瘤或癌症 AMPK相关通路，
Wnt /β-catenin信号通路，
IL-6 / STAT3通路等M1：IFN-γ，胎盘生长因子（PLGF），铜绿假单胞菌（ 绿脓杆菌） 甘露糖敏感血凝菌毛株（PA-MSHA）等
M2：Wnt配体，miR-21-5p， lncRNA cox-2（*）等（*）为负向调控，未特别说明即为正向调控。 
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