炎症介质在高血压左心室重构中的作用

The influences of inflammatory mediators on left ventricular remodeling of hypertension

左心室重构作为高血压靶器官损害之一,与心脏事件、心脏外靶器官损害均密切相关。高血压左心室重构受到机械刺激、神经体液因素和炎症反应等多种因素影响。多种炎症介质可通过影响心肌细胞生长、心脏成纤维细胞转化和分泌基质蛋白,改变细胞外基质的含量与组成以及改变冠状动脉的结构与功能而影响高血压左心室重构的发生和发展。此外,炎症介质还可相互作用,并参与介导高血压左心室重构的机械负荷和神经体液机制,组成复杂的网络系统,从多个靶点、多个环节对高血压左心室重构产生重要影响。临床常用降压药ACEI和CCB均可通过作用于炎症介质而延缓和(或)逆转高血压左心室重构的进程。

As one of the hypertensive target organ damage, left ventricular remodeling is closely related to heart attacks and extracardiac target organ damage. Left ventricular remodeling of hypertension is influenced by mechanical stimuli, neurohumoral factors, inflammation, ect. Many kinds of inflammatory mediators affect the onset and process of hypertensive left ventricular remodeling by influencing myocardial cell growth, cardiac fibroblasts transforming and secreting matrix proteins, changing the content and composition of extracellular matrix, and changing the structure and function of coronary arteries. In addition, inflammatory mediators interact with each other, and participate in the mechanical and neurohumoral mechanisms of hypertensive left ventricular remodeling, thus composing a complex network system, which influences left ventricular remodeling of hypertension greatly by multiple targets and pathways. Common clinical antihypertensive drugs such as ACEI and CCB can delay and/or reverse left ventricular remodeling of hypertension process by acting on inflammatory mediators.