细胞凋亡在缺血性心肌病中作用的研究进展

Research progress of apoptosis in ischemic cardiomyopathy

细胞凋亡在急性心肌梗死（AMI）后心脏损伤中起着重要的作用，并且参与AMI后的左心室重构和有症状心功能衰竭的发生。发现细胞凋亡的敏感生物标志物有助于评估AMI患者的预后，并对寻找新的治疗方案具有重要意义。细胞凋亡的起始途径有外在的死亡受体途径和内在的线粒体途径，两个途径在相同的终末通路上汇集。肿瘤坏死因子相关性凋亡诱导配体（TRAIL）是评价AMI患者预后的重要标志物。现就细胞凋亡在缺血性心肌病发病过程以及凋亡标志物在临床治疗中的应用价值进行综述。

Apoptosis plays an important role in the myocardial injury after acute myocardial infarction （AMI） and participates in the process of subsequent left ventricular remodeling and development of symptomatic heart failure. The discovery of sensitive markers of apoptosis is helpful to evaluate the prognosis of patients with AMI, and it is of great significance to look for a new therapeutic strategy. There are external or death receptor pathway and intrinsic or mitochondrial pathway in the initiation of apoptosis, and the two pathways converge in a same terminal pathway. The tumor necrosis factor-related apoptosis inducing ligand （TRAIL） represents a very promising marker that can be used to evaluate the prognosis of patients with AMI. This paper reviews the role of apoptosis in the pathogenesis of ischemic cardio-myopathy and the application value of apoptosis markers in clinical treatment.