emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университет10.51922/2616-633X.2023.7.2.1903emcardio-17Research ArticleМастер-классMaster-classМикроциркуляция (часть 1 – главные действующие «лица» и их роль в системе кровообращения)Microcirculation (part 1 – main players and their role in the circulatory system)ЦапаеваН. Л.TsapaevaN. L.

г. Минск

Minsk

ntsapaeva@yandex.ruЦапаевВ. Г.TsapaevV. G.

г. Минск

Minsk

УО «Белорусский государственный медицинский университет»Belarusian State Medical University2023190620257219031910Copyright © Цапаева Н.Л., Цапаев В.Г., 20252025Цапаева Н.Л., Цапаев В.Г.Tsapaeva N.L., Tsapaev V.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/17

В статье представлены современные взгляды на микроциркуляцию, которая является терминальным компартментом сердечно-сосудистой системы, встроенным в структуру тканей и определяющим целевую функцию кровообращения – обмен между кровью и тканями субстратами энергией и информацией, что обеспечивает поддержание процессов жизнеобеспечения на уровне клеток. Отражены гемодинамические особенности, определяющие основные функции микроциркуляторных сосудов как важнейшего звена кровообращения. Подробно изложена структура и морфофункциональные особенности всех уровней микроциркуляции, включающей мельчайшие сосуды терминального русла, которые сохраняют морфологическое строение артерий и вен. Выделены основные механизмы регуляции артериолярного кровотока: нейрогуморальный, миогенный, метаболический. Дана подробная характеристика эндотелию. Отмечена роль барьерной функции эндотелия в поддержке баланса между осмотическим и гидростатическим давлением и в формировании лимфатической системы для дренирования избытка интерстициальной жидкости. Представлены результаты исследований, посвященных микрососудистым эндотелиальным клеткам, в которых особенно активны гены, кодирующие белки базальных мембран. Акцентируется внимание на морфологических и функциональных свойствах гликокаликса эндотелиальной клетки как новой клинической парадигмы. Гликокаликс присутствует во всех капиллярах, артериях и венах и представляет собой структуру дистантного взаимодействия эндотелиальных клеток с окружающей их средой, изменяясь при патологических состояниях (адгезия, тромбообразование, апоптоз).

The article presents modern views on microcirculation, which is the terminal compartment of the cardiovascular system, built into the tissue structure and determining the target function of blood circulation – the exchange between blood and tissues of substrates, energy and information, which ensures the maintenance of life support processes at the cellular level. The paper highlights the hemodynamic features that determine the main functions of microcirculatory vessels as the most important part of the blood circulation. The structure and morphofunctional features of all levels of microcirculation including the smallest vessels of the terminal bed, which preserve the morphological structure of arteries and veins, are described in detail. The main mechanisms of regulation of arteriolar blood flow are identified: neurohumoral, myogenic, and metabolic. A detailed description of the endothelium is given. The role of the barrier function of the endothelium in maintaining the balance between osmotic and hydrostatic pressure and in the formation of the lymphatic system for drainage of excess interstitial fluid has been noted. The results of studies on microvascular endothelial cells, in which genes encoding basement membrane proteins are especially active, are presented. Attention is focused on the morphological and functional properties of the endothelial cell glycocalyx as a new clinical paradigm. The glycocalyx is present in all capillaries, arteries and veins and is a structure of distant interaction of endothelial cells with their environment, changing under pathological conditions (adhesion, thrombus formation, apoptosis).

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The authors declare that there are no conflicts of interest present.