心脏淋巴管生成在心血管疾病中的最新研究进展

doi:10.12092/j.issn.1009-2501.2026.05.010

摘要/Abstract

摘要：

心脏淋巴管生成在维持组织-液体平衡、免疫反应和脂质吸收中起主要作用，但心脏淋巴重塑受损/过度以及淋巴引流不足与多种心血管疾病的发生有关。本综述重点总结了心脏淋巴管生成的分子调控机制，并剖析其在心血管疾病中的动态作用，也探讨了淋巴-免疫互作机制在心肌组织损伤修复中的影响，以及靶向淋巴管生成在心血管疾病治疗中的潜在价值。淋巴管生成早期可能通过清除代谢废物、减轻水肿促进修复，而慢性期的过度激活或功能障碍则可能加剧纤维化与炎症扩散。因此，深入探究心脏淋巴管生成在心血管疾病中的作用机制，将为开发新的治疗策略提供重要理论依据。

关键词: 淋巴管生成, 心血管疾病, 调节因子, 淋巴-免疫, 治疗策略

Abstract:

Cardiac lymphatics play a major role in the maintenance of tissue-fluid homeostasis, immune response, and lipid uptake. However, impaired/excessive cardiac lymphatic remodeling and inadequate lymphatic drainage are associated with the development of several cardiovascular diseases (CVDs). This review systematically summarizes the molecular mechanisms of cardiac lymphangiogenesis and elucidates their dynamic role in CVDs. Meanwhile, this article also explores the role of lymphatic-immune interactions in the repair process of myocardial tissue injury and the potential value of targeted lymphangiogenesis in the treatment of CVDs. Early stages of lymphangiogenesis may promote repair by removing metabolic waste and reducing edema, whereas hyperactivation or dysfunction in the chronic phase may exacerbate fibrosis and the spread of inflammation. Therefore, an in-depth study of the cardiac lymphangiogenesis in CVDs will provide an important theoretical basis for the development of new therapeutic strategies.

Key words: lymphangiogenesis, cardiovascular diseases, regulatory factors, lymphatic-immune, therapeutic strategies

中图分类号:

R541

杨雅坤, 樊官伟, 李澜. 心脏淋巴管生成在心血管疾病中的最新研究进展[J]. 中国临床药理学与治疗学, 2026, 31(5): 658-665.

Yakun YANG, Guanwei FAN, Lan LI. Recent advances of cardiac lymphangiogenesis in cardiovascular disease[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2026, 31(5): 658-665.

图/表 2

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疾病类型	关键调节因子变化	功能影响
动脉粥样硬化	VEGF-C/VEGFR-3表达↑，炎症因子激活	斑块周围淋巴管生成，斑块内淋巴引流不足导致脂质积累
高血压	VEGF-C↑？，Ang Ⅱ抑制淋巴管生成	淋巴管功能不全，加剧心肌间质水肿，长期促进心肌纤维化
心肌梗死	VEGFR-3、PROX1↑（早期）；VEGF-C/VEGF-D/ VEGFR-3↓（晚期）	淋巴管再生减轻水肿，改善修复（早期）；晚期过度生成可能促进纤维化
非缺血性心肌病	CCL21、VEGF-C、VEGF-D↑（代偿性）	淋巴管稀疏导致慢性水肿，心肌僵硬度↑，舒张功能恶化
心肌炎	炎症因子↑	淋巴管功能损伤加重炎症扩散，水肿和免疫细胞浸润加剧收缩功能障碍
心力衰竭	LYVE1、PROX1↓	淋巴回流不足导致慢性水肿，纤维化加重，射血分数进一步下降
心脏移植	排斥反应中VEGFR3↓	淋巴管损伤加剧移植心脏水肿，排斥反应中淋巴- 免疫交互促进慢性排斥

疾病类型	关键调节因子变化	功能影响
动脉粥样硬化	VEGF-C/VEGFR-3表达↑，炎症因子激活	斑块周围淋巴管生成，斑块内淋巴引流不足导致脂质积累
高血压	VEGF-C↑？，Ang Ⅱ抑制淋巴管生成	淋巴管功能不全，加剧心肌间质水肿，长期促进心肌纤维化
心肌梗死	VEGFR-3、PROX1↑（早期）；VEGF-C/VEGF-D/ VEGFR-3↓（晚期）	淋巴管再生减轻水肿，改善修复（早期）；晚期过度生成可能促进纤维化
非缺血性心肌病	CCL21、VEGF-C、VEGF-D↑（代偿性）	淋巴管稀疏导致慢性水肿，心肌僵硬度↑，舒张功能恶化
心肌炎	炎症因子↑	淋巴管功能损伤加重炎症扩散，水肿和免疫细胞浸润加剧收缩功能障碍
心力衰竭	LYVE1、PROX1↓	淋巴回流不足导致慢性水肿，纤维化加重，射血分数进一步下降
心脏移植	排斥反应中VEGFR3↓	淋巴管损伤加剧移植心脏水肿，排斥反应中淋巴- 免疫交互促进慢性排斥

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