Schipke Jochen D, Kerendi Faraz, Gams Emmeran, Vinten-Johansen Jakob
Forschungsgruppe Experimentelle Chirurgie, Zentrum Operative Medizin I, Universitätsklinikum Düsseldorf, Düsseldorf.
Herz. 2006 Sep;31(6):600-6. doi: 10.1007/s00059-006-2842-6.
Preconditioning is the most effective form of cardioprotection that can be induced via different interventions before a longer-lasting ischemia (= index ischemia). Preconditioning can be induced by short bouts of ischemia, several pharmaceuticals (e.g., adenosine), and volatile anesthetics. A brief ischemia of an organ other than the heart can likewise initiate protection of the heart, which has been called preconditioning at a distance or remote preconditioning. According to the more recent literature, short bouts of ischemia after an index ischemia can also initiate cardioprotection, e.g., improve postischemic dysfunction or reduce infarct size, which has been called postconditioning. Such a postconditioning can also be elicited at a distant organ, termed remote postconditioning. It is the aim of this short review to characterize preconditioning and in particular postconditioning, describe possible mechanisms, and call attention to the clinical relevance.
预处理是最有效的心脏保护形式,可通过在较长时间缺血(即指数缺血)之前进行不同干预来诱导。预处理可由短暂的缺血发作、几种药物(如腺苷)和挥发性麻醉剂诱导。心脏以外器官的短暂缺血同样可启动对心脏的保护作用,这被称为远程预处理或远隔预处理。根据最新文献,指数缺血后的短暂缺血发作也可启动心脏保护作用,例如改善缺血后功能障碍或减小梗死面积,这被称为后处理。这种后处理也可在远处器官引发,称为远程后处理。本简短综述的目的是对预处理尤其是后处理进行特征描述,阐述可能的机制,并提请关注其临床相关性。