摘要
心肌缺血再灌注(ischemia/reperfusion,I/R)损伤是在冠心病、中风、心脏骤停和复苏、器官移植、休克等事件后缺血或闭塞的冠状动脉恢复供血时发生的病理改变。心肌I/R损伤常伴有心血管不良事件,严重影响心肌缺血的预后。心肌I/R损伤的潜在机制复杂,涉及氧自由基损伤、钙超载、炎症反应、细胞凋亡、补体激活、免疫失衡、内质网应激、细胞自噬、心肌能量代谢紊乱、心肌微血管内皮细胞损伤等多种病理过程。为减轻I/R损伤,缺血预处理是一种有效的防治措施。目前相关发病机制与防治措施实验性研究较多,但临床应用仍然有限,因此I/R损伤的防治仍然是一大挑战。心肌I/R损伤的发病机制不完全明确,治疗方法和药物有限,故本文对其损伤涉及的分子机制和相关信号通路以及新兴靶向治疗的研究做一总结,为心肌I/R损伤的临床防治提供治疗策略和理论依据。
Myocardial ischemia/reperfusion(I/R) injury is a pathological change that occurs during the restoration of blood supply to ischemic or occluded coronary arteries after coronary heart disease,stroke,cardiac arrest and resuscitation,organ transplantation,shock and other events. Myocardial I/R injury is often accompanied by cardiovascular adverse events,which seriously affect the prognosis of myocardial ischemia. The potential mechanism of myocardial I/R injury is complex,involving many pathological processes,such as oxygen free radical injury,calcium overload,inflammation,apoptosis,activation,immune imbalance,endoplasmic reticulum stress,autophagy,myocardial energy metabolism disorder,myocardial microvascular endothelial cell injury and so on. Ischemic preconditioning is an effective preventive and therapeutic measure to reduce ischemia-reperfusion(I/R)injury. At present,there are many experimental studies on the pathogenesis and prevention and treatment measures,but the clinical application is still limited,so the prevention and treatment of I/R injury is still a major challenge. The pathogenesis of myocardial I/R injury is not completely clear,and the treatment methods and drugs are limited,so this paper summarizes the molecular mechanism and related signal pathways involved in its injury,as well as the emerging targeted therapy,to provide strategy and theoretical basis for clinical prevention and treatment of myocardial I/R injury.
作者
魏成露
冯庆敏
陈宋程
卓怀蜜
李继科
WEI Cheng-lu;FENG Qing-min;CHEN Song-cheng;ZHUO Huai-mi;LI Ji-ke(Hainan Medical University,Haikou 571199,China)
出处
《海南医学院学报》
CAS
2022年第16期1268-1274,共7页
Journal of Hainan Medical University
基金
国家自然科学基金资助项目(81660064)。
关键词
心肌细胞
缺血再灌注损伤
分子机制
信号通路
Ischemia/reperfusion injury
Myocardial
Molecular mechanism
Signal transduction pathway