阿片受体激动剂对缺血/再灌注心肌的保护作用

Protection of opioid receptor agonist for ischemia-reperfusion cardiac muscle

近来,随着溶栓和介入治疗的发展,AMI再灌注成功率显著提高。但是,血管再通时随之可能会发生缺血心肌的再灌注损伤。已证实缺血预处理(IPC)可产生心肌保护作用。而阿片受体激动剂通过激活心肌阿片受体能模拟缺血预处理对心脏的保护作用,心肌阿片受体激活能产生早期时相和后时相的心肌保护作用,信号途径涉及Gi/Go、蛋白激酶C、酪氨酸激酶和ATP敏感钾离子通道等。另外,阿片受体激动药对缺血/再灌注心肌也可产生直接的保护作用。但其作用机制有待于进一步的研究。

Recently, with the development of thrombolysis and interventional therapy, the successful rate of AMI reperfusion have be greatly improved, but ischemia - reperfusion injury of ischemic cardiac muscle may happen. It had been confirmed ischemia preconditioning （ IPC ） could protect ischemia cardiac muscle, and opioid receptor agonist can simulate IPC ＇s protection for ischemia cardiac muscle by activating opioid receptor of cardiac muscle. Opioid receptor of cardiac muscle plays a role in the protec- tion of ischemia cardiac muscle at the early stage and late stage, and the signal channel is related to Gi/ Go, protein kinase C, tyrosine kinase and ATP sensitive K^＋ passage. On the other side, opioid receptor agonist has direct protection role in ischemia - reperfusion cardiac muscle, but further study is needed.