临床应用心肌缺血预适应与后适应的哲学理论

The Philosophy Theory of Myocardial Ischemic Preconditioning and Postconditioning Applicied in Clinic

及时恢复缺血区的血液灌注即再灌注是临床上挽救缺血心肌的最有效措施,但再灌注会引起严重的再灌注损伤。心肌缺血预适应和后适应可以减轻缺血再灌注损伤后心肌的坏死与心肌功能障碍,减少恶性心律失常的发生,是减轻缺血再灌注损伤的有效内源性保护手段。心肌缺血预适应和后适应的机制主要是通过诱导触发因子释放,经多条细胞内信号转导途径的介导,作用于多种效应器,影响缺血再灌注损伤的关键环节而发挥心肌细胞保护作用。心肌缺血预适应和后适应是内因和外因的辩证统一,也蕴含矛盾双方互相转化的规律。

Restoration of blood flow is the definitive therapy to salvage myocardium ischemic injury.Sudden restoration of blood flow to the ischemic myocardium,however,also cause reperfusion injury.Myocardium ischemic preconditioning and ischemic postconditioning are endogenous protective mechanisms capable of protecting the myocardium from myocardial infarction,stunning,and ventricular arrhythmia induced by ischemia/reperfusion injury.The mechanisms involve induction of triggers,activation of signaling pathways,and end-effectors,which affect critical link induced by ischemia/reperfusion injury.Ischemic preconditioning and ischemic postconditioning is the dialectical unity of external cause and internal cause.