内皮细胞损伤与心肌无复流现象

Endothelial Cell Injury and Myocardial No-reflow

内皮系统是一个动态的平衡系统,对于维持局部内环境的稳定十分重要。已经证实内皮细胞结构完整及功能正常对血管壁通透性屏障、免疫防御、抗凝、抗血栓及炎性反应均有重要作用。血管内皮细胞损伤与心肌无复流密切相关,可显著降低急性心肌梗死病人的生存率,防治血管内皮细胞损伤是临床工作的重要难题。研究显示:心肌缺血-再灌注易导致内皮细胞结构及功能损伤,促进无复流的发生发展;相应的临床干预措施在一定程度上可修复损伤内皮细胞,改善心肌无复流。本文主要针对缺血-再灌注时内皮细胞损伤的最新发生机制及临床处理做一综述,以期为防治心肌无复流提供理论依据。

Endothelial system is a dynamic balance system to maintain the normal flow of blood, which is very important to maintain local homeostasis. It has been confirmed that endothelial cell integrity of the structure and function are important to the normal vessel wall permeability barrier, immune defense, anticoagulant, antithrombotic and anti-inflammatory response. Microvascular endothelial cell damage is closely related to myocardial no-reflow, which can significantly reduce the survival rate of patients with no-reflow, being clinical treatment challenges. Studies have shown ischemia-reperfusion results in structure and function of endothelial cell injury, which promote the development of no-reflow. The corresponding clinical intervention measures in a certain extent can repair the damage of endothelial cells and improve myocardial no-reflow to a certain extent. The latest endothelial cell injurious mechanism and clinical treatment application are reviewed here, in order to provide new theoretical basis of prevention of myocardial no-reflow for clinical treatment.