低氧诱导因子-1在冠状动脉粥样硬化性心脏病患者围术期心肌保护作用的研究进展

Progress on perioperative myocardial protection of hypoxia-inducible factor-1 in coronary heart disease patients

背景 低氧是围术期诱发冠状动脉粥样硬化性心脏病（冠心病）患者出现心脏不良事件重要的病理生理因素。低氧诱导因子-1（Hypoxia-inducible factor-1，HIF-1）作为低氧应答时基因表达和恢复细胞内环境稳定的调节中心，可以稳定地表达并调控一系列低氧相关基因，引起血管新生、血管平滑肌舒缩、抑制血小板凝聚和红细胞增生等变化，从而有可能成为治疗冠心病最有前途的潜在作用靶点。目的 就H1F-1对冠心病患者围术期心肌保护作用的研究进展作一综述。内容 描述HIF-1的结构，HIF-1与低氧的关系，HIF-1及其靶基因对冠心病发生发展的作用机制，HIF-1对冠心病患者围术期心肌保护作用机制，冠心病患者围手术期检测HIF-1的意义。趋向 HIF-1有可能成为冠心病患者围术期心肌保护最有前途的靶基因之一，但对HIF-1的临床应用还需要深入研究和不断探索，以充分发挥其应有的医学价值。

Background Hypoxia is the important pathophysiologieal factor in coronary heart disease patients during perioperative to induce the adverse cardiac events. As a regulation center of gene expression and recovery intraeellular homeostasis of hypoxia-related genes, induce angiogenesis, vascular smooth muscle relaxation in hypoxia response, HIF-1 can express, and regulate the expression of a series and contraction stabily, and induce angiogenesis, vascular smooth muscle relaxation and contraction, inhibition of platelet aggregation, red cell hyperplasia and the progression of coronary atherosclerosis, so it is likely to be the most promising and effective treatment for coronary artery disease. Objective To make a summary about progress on perioperative myocardial protection of hypoxia-inducible factor-1 in coronary heart disease patients. Content This paper describes structure of HIF-1, relationship between hypoxia and HIF-1, the mechanism of HIF-1 and it＇s target gene play role on the development of coronary artery disease,the mechanism of HIF-l＇s perioperative myocardial protection in coronary heart disease,the significance of perioperative test HIF-1 in coronary heart disease patients. Trend HIF-1 is likely to be the most promising and effective treatment for coronary artery disease during preoperative. The clinical application of HIF-1 still needs to be studied deeply and explored continuously.