长链脂酰辅酶A与心肌缺血再灌注损伤胰岛素抵抗的研究进展

The progress of long - chain fatty acyl - CoA in myocardial insulin resistance during myocardial ischemia - reperfusion injury

体外循环（CPB）是现如今心内直视手术的重要手段，而心肌缺血再灌注损伤（MIRI）被认为是临床心内直视手术术后导致死亡和阻碍心脏功能恢复的最重要原因。有研究报道，急性心肌胰岛素抵抗（IR）很可能成为心肌缺血再灌注后MIRI的又一个新的机制。脂肪酸和葡萄糖作为心肌细胞主要的两类能量底物，在IR发生过程中存在严重的代谢紊乱。而长链脂酰辅酶A（LCACoA）作为脂肪酸代谢的一个重要的中间产物，也是一个重要的信号分子，与IR的发生有着紧密的联系，在调节脂肪酸和葡萄糖代谢中发挥着重要的作用，并认为其可作为研究脂代谢的一个新的指标。

Nowadays, cardiopulmonary bypass （CPB） is an important means of open - heart surgery, and my- ocardial ischemia- reperfusion injury （MIRI） is considered to be the main cause of the death and affecting the cardiac function recovery after clinical open - heart surgery. Recent studies show that, acute myocardial insulin resistance （IR） after myocardial ischemia - reperfusion is likely to become another important mechanism of MIRI. There are mainly two types of energy substrate fatty acid and glucose metabolism disorders in the process of myocardial IR. Long - chain fatty acyl coenzyme A （ LCACoA ）, as a crucial intermediate of fatty acid metabolism, is an important sig- nal molecule and closely related to the occurrence of IR, and plays an important role in regulating fatty acid and glu- cose metabolism. It can be used as a new index of lipid metabolism research in fatty acid metabolism, and be expected to provide important basis and target for the prevention and therapy of myocardial IR and MIRI.