Opie L H
Medical Research Council, University of Cape Town Ischaemic Heart Disease Research Unit, South Africa.
Cardiovasc Drugs Ther. 1990 Aug;4 Suppl 4:777-90. doi: 10.1007/BF00051275.
Evidence is reviewed that favors the hypothesis that maintenance of glycolysis plays a special role in protecting membrane function in ischemia. Therefore all procedures stimulating glycolytic flux should be beneficial in ischemia, and procedures inhibiting flux should be harmful. However, a crucial consideration is the coronary flow rate. In severe ischemia, accumulation of protons, derived not directly from glycolytic flux but from the breakdown of ATP and from proton-producing cycles, will tend to inhibit glycolysis and to minimize any benefit from increased glycolytic flux. Therefore maintenance of intracellular pH is crucial to the concept of the benefits of glycolysis. It also follows that the severity of ischemia can determine whether or not enhanced glycolysis has a beneficial effect. It is argued that a multiple approach, including enhanced glycolytic flux, control of intracellular pH, and improved coronary flow, constitutes the combination most likely to benefit ischemia.
糖酵解的维持在缺血时保护膜功能方面发挥特殊作用。因此，所有刺激糖酵解通量的程序在缺血时应是有益的，而抑制通量的程序则应是有害的。然而，一个关键的考虑因素是冠状动脉血流速度。在严重缺血时，质子的积累并非直接源于糖酵解通量，而是来自ATP的分解和产质子循环，这将倾向于抑制糖酵解，并使糖酵解通量增加带来的任何益处最小化。因此，维持细胞内pH对于糖酵解有益这一概念至关重要。由此还可推断，缺血的严重程度可决定增强的糖酵解是否具有有益效果。有人认为，包括增强糖酵解通量、控制细胞内pH和改善冠状动脉血流在内的多种方法构成了最有可能使缺血受益的组合。
