心肌支架材料在心肌梗死治疗中的应用与研究热点

Research progress of myocardial scaffolds in the treatment of myocardial infarction

背景:近年来心肌组织工程快速崛起,通过应用外源性生物材料模拟细胞外基质,使受损的心肌细胞得到有效修复或重建,在治疗心肌梗死等缺血性心脏病方面具有很大的潜在价值。目的:综述心肌支架材料在心肌梗死治疗应用中的研究进展。方法:应用计算机检索NCBI数据库和万方数据2008至2018年发表的相关文献,检索关键词为"心肌支架材料,心肌梗死;Myocardial scaffold materials,myocardial infarction"。结果与结论:目前常用的心肌支架材料主要有天然生物材料(包括胶原/Matrigel、纤维蛋白、壳聚糖、透明质酸、海藻盐酸等)、人工合成材料(聚酯类人工合成材料与纳米材料)及复合支架材料。由于心脏环境和心脏功能的复杂性,支架材料的选择应充分考虑到生物相容性、免疫原性、导电性、降解率、对缺血缺氧易感性等各方面因素,尽管目前许多支架设计开始满足所提出的诸多要求,但应用于临床仍然存在着各种各样的问题,相信随着研究者的进一步深入及应用工具的进一步发展,人们可期待能够创造出接近原生组织生理机能的心肌支架,使心脏功能得到更理想的恢复。

BACKGROUND: In recent years, myocardial tissue engineering has developed rapidly. By using exogenous biomaterials to simulate extracellular matrix, damaged myocardial cells can be effectively repaired or reconstructed, which has great potential value in the treatment of ischemic heart diseases such as myocardial infarction. OBJECTIVE: To review the research progress of myocardial scaffolds in the treatment of myocardial infarction. METHODS: NCBI and WanFang databases were retrieved for relevant articles published from 2008 to 2018, with the key words of “myocardial scaffold materials, myocardial infarction” in English and Chinese, respectively. RESULTS AND CONCLUSION: At present, the commonly used myocardial scaffolds are mainly natural biomaterials (including collagen/ Matrigel, fibrin, chitosan, hyaluronic acid, and algae hydrochloric acid), synthetic materials (polyester synthetic materials and nanomaterials) and composite scaffolds. Due to the complexity of cardiac environment and heart function, the selection of scaffold materials should fully take account of biocompatibility, immunogenicity, conductivity, degradation rate and susceptibility to ischemia and hypoxia. Although many scaffold designs have begun to meet many requirements, there are still many kinds of stent materials for clinical application. It is believed that with the further development of researchers and application tools, people can expect to create myocardial scaffolds close to the physiological function of the original tissue, so that the heart function can be better restored.