铁死亡在中医药治疗心力衰竭中的机制研究进展

Mechanism of Ferroptosis in Chinese Medicine Treatment of Heart Failure:A Review

心力衰竭是多种病因导致的心脏疾病最终阶段,具有较高的患病率、死亡率、伤残率,成为医疗领域的一大难题。心肌细胞是构成心脏的最基本单位,其特点具有不可逆性,发生心力衰竭时会导致心肌细胞出现各种各样的损伤或坏死。心肌细胞损伤也是导致患者心脏功能障碍、影响其预后与生存质量的关键原因。因此,减轻心肌细胞损伤程度,延缓其细胞死亡进程有利于降低心力衰竭患者的心功能损伤水平,改善其预后效果,进而降低病死、病残率和住院次数。铁死亡是近年来被广泛关注的新型细胞死亡形式,已有研究证实心肌细胞存在铁死亡现象。作为一种可调节的细胞死亡形式,干预铁死亡可以实现对心肌细胞损伤程度与死亡进程的调节。研究表明抑制铁死亡可以起到对心肌细胞保护性作用,进而治疗心力衰竭。中医药已被广泛应用于心力衰竭的临床诊疗中,具有多途径、多切入点的优势,治疗效果显著、安全且不良反应低、医疗费用少,还降低西药的临床不良作用,并取得了较好的临床效果。以中医药调节铁死亡作为切入点可能是未来治疗心力衰竭的新方向。该文简要阐述铁死亡机制,研究铁死亡在心力衰竭中的作用,探讨中医药干预心力衰竭中的铁死亡研究现状,为进一步提升中医治疗心力衰竭的疗效提供参考。

Heart failure is the final stage of heart disease caused by a variety of etiologies and has a high morbidity,mortality,and disability rate,making it a major challenge in the field of medicine.Cardiomyocytes,the most basic unit of the heart,are irreversible in nature and can be damaged or necrotic in various ways in the presence of heart failure.Myocardial cell injury is also an important cause of cardiac dysfunction and affects the prognosis and quality of life of patients.Therefore,reducing the level of myocardial cell damage and delaying the process of cell death can help patients with heart failure lessen the extent of cardiac damage and improve their prognosis,thereby lowering the incidence of death and disability and times of hospitalization.Ferroptosis is a new form of cell death that has been widely concerned in recent years,with studies confirming its occurrence in cardiac myocytes.As a modifiable form of cell death,interfering with ferroptosis can modulate the extent of injury and death in cardiac myocytes.Studies have shown that the inhibition of iron death has a protective effect on cardiomyocytes,thereby alleviating heart failure.Chinese medicine has been widely used in the clinical treatment of heart failure,and has the advantages of multiple approaches and entry points,with significant therapeutic effects,low side effects,and low medical costs.It also reduces the clinical side effects of western medicine,with good clinical results.The use of Chinese medicine to modulate ferroptosis may be a new direction for the future treatment of heart failure.This paper briefly elaborated on the mechanism of ferroptosis,investigated the role of ferroptosis in heart failure,and discussed the current status of research on ferroptosis in Chinese medicine interventions in heart failure,to provide references for further improving the efficacy of Chinese medicine in the treatment of heart failure.