血浆三甲胺N-氧化物与心肌梗死关系的研究进展

Advances in the Relationship Between Plasma Trimethylamine N-oxide and Myocardial Infarction

三甲胺N-氧化物(TMAO)是一种在肝脏中由肝酶氧化三甲胺(TMA)生成的产物,是常见的肠道菌群代谢物,与心血管疾病密切相关。近年来,国内外研究发现血浆TMAO水平与心肌梗死(MI)及后期不良心血管事件的再次发生均有较强的临床相关性,可作为心血管疾病新发现的危险因子。该文对相关文献总结,发现高水平TMAO通过提高血小板活性,促进泡沫细胞形成,影响胆汁酸合成,导致内皮细胞功能障碍等机制,提高MI的发生率。同时血浆TMAO水平受饮食、药物[抗菌药物、3,3-二甲基-1-丁醇(DMB)]、运动等因素影响,可为MI治疗提供新的临床思路。

Trimethylamine N-oxide(TMAO),a product produced from trimethylamine oxide(TMA)in the liver by the hepatic enzymes,is a common metabolite of intestinal flora and is closely associated with cardiovascular diseases.In recent years,domestic and international studies have found a strong clinical correlation between plasma TMAO levels and myocardial infarction(MI)and the reoccurrence of late adverse cardiovascular events,which can be used as a newly identified risk factor for cardiovascular diseases.This review summarizes the relevant literatures and finds that high levels of TMAO increase the incidence of MI through mechanisms such as increased platelet activity,promoting foam cell formation,affecting bile acid synthesis,and causing endothelial cell dysfunction.Meanwhile,plasma TMAO levels are influenced by diet,drugs[antibacterial drugs,3,3-dimethyl-1-butanol(DMB)],and exercise,etc..It can provide new clinical ideas for the treatment of MI.