缺血后适应对减少心肌缺血再灌注损伤的研究进展

Research Progress in Ischemic Post-Conditioning for Reducing Myocardial Ischemia-Reperfusion Injury

再灌注是治疗急性心肌梗死的有效方法,对于减少心肌梗死面积、降低病死率有重要意义。但随着研究的深入发现,再灌注治疗也会导致心肌梗死面积增大、心律失常等,严重威胁患者的生命安全。缺血后适应(IPost C)是改善心肌缺血再灌注损伤的有效措施,通过对病变血管、远隔血管床或药物进行短暂的缺血再灌注治疗,从而降低再灌注损伤,根据作用的部位分为原位IPost C、远隔IPost C以及药物IPost C。大量的临床研究表明,IPost C能显著降低急性心肌梗死患者的再灌注损伤,提高患者的生存率、改善预后,但IPost C的作用机制以及最佳作用血管以及药物还需要进一步研究。

Reperfusion is an effective method for the treatment of acute myocardial infarction,which is of great significance for reducing myocardial infarct size and mortality.However,with the deepening of the research,it’s discovered that reperfusion therapy may also increase myocardial infarct size and result in arrhythmia,which seriously threatens the lives of patients.Ischemic post-conditioning(IPostC) is an effective measure to improve myocardial ischemia-reperfusion injury by transient ischemia reperfusion treatment of diseased vessels,distant vascular beds or drugs,thereby reducing reperfusion injury .Depending on the site of action,it′s divided into in situ IPostC,remote IPostC and drug IPostC.A large number of clinical studies have shown that IPostC can significantly reduce reperfusion injury in patients with acute myocardial infarction,improve patients′ survival rate and prognosis,but the action mechanism of IPostC and optimal acting blood vessels and drugs still need further studies.