心肌纤维化的发病机制及治疗进展

Progress in pathogenesis and therapeutics of myocardial fibrosis

心肌纤维化是多种心脏疾病的共同病理特征.其发病机制有:肌成纤维细胞介导的细胞外基质重塑、心肌胶原纤维成分比例失衡、细胞因子及炎性介质活化、肾素-血管紧张素-醛固酮系统(renin-angiotensin aldosterone system,RASS)过度激活以及microRNA的调控.目前抗心肌纤维化的治疗主要有RASS相关药物、他汀类、信号通路抑制剂、钙通道阻滞剂、基因治疗以及中医药辅助治疗.

Myocardial fibrosis is a common pathological feature of many heart diseases.Its pathogenesis includes extracellular matrix remodeling mediated by myofibroblasts,imbalance of myocardial collagen fiber composition,activation of cytokines and inflammatory mediators,renin angiotensin aldosterone system overactivation and microRNA regulation.The current anti-myocardial fibrosis treatment includes ACEI,ARB,HMG-CoARI,signaling pathway inhibitors,calcium channel blockers,gene therapy and Chinese medicine adjuvant therapy.