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缺血/再灌注损伤中的血脂异常。

Dyslipidemia in Ischemia/Reperfusion Injury.

机构信息

Institute of Cardiovascular Physiopathology and Department of Pathology and Institute of Biochemistry and Molecular Medicine (IBIMOL UBA-CONICET), Faculty of Medicine, University of Buenos Aires, Buenos Aires, Argentina.

Institute of Biochemistry and Molecular Medicine (IBIMOL UBA-CONICET) School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina.

出版信息

Adv Exp Med Biol. 2019;1127:117-130. doi: 10.1007/978-3-030-11488-6_8.

Abstract

Ischemic heart disease is the main cause of morbidity and mortality in the developed world. Although reperfusion therapies are currently the best treatment for this entity, the restoration of blood flow leads, under certain circumstances, to a form of myocardial damage called reperfusion injury. Several studies have shown that age, sex, smoking, diabetes and dyslipidemia are risk factors for cardiovascular diseases. Among these risk factors, dyslipidemias are present in 40% of patients with ischemic heart disease and represent the clinical factor with the greatest impact on the prognosis of patients with cardiovascular diseases. It is known that during reperfusion the increase of the oxidative stress is perhaps one of the most important mechanisms implicated in cell damage. That is why several researchers have studied protective mechanisms against reperfusion injury, such as the ischemic pre- and post- conditioning, making emphasis mainly on the reduction of oxidative stress. However, few of these efforts have been successfully translated into the clinical setting. The controversial results in regards to the relation between cardioprotective mechanisms and dyslipidemia/hypercholesterolemia are mainly due to the difference among quality, composition and the time of administration of hypercholesterolemic diets, as well as the difference in the species used in each of the studies. Therefore, in order to compare results, it is crucial that all variables that could modify the obtained results are taken into consideration.

摘要

缺血性心脏病是发达国家发病率和死亡率的主要原因。尽管再灌注疗法是目前治疗这种疾病的最佳方法,但在某些情况下,血流的恢复会导致一种称为再灌注损伤的心肌损伤。多项研究表明,年龄、性别、吸烟、糖尿病和血脂异常是心血管疾病的危险因素。在这些危险因素中,血脂异常在 40%的缺血性心脏病患者中存在,是对心血管疾病患者预后影响最大的临床因素。众所周知,在再灌注过程中,氧化应激的增加可能是细胞损伤中最重要的机制之一。这就是为什么许多研究人员研究了针对再灌注损伤的保护机制,如缺血预处理和后处理,并主要强调降低氧化应激。然而,这些努力很少成功转化为临床实践。关于保护性机制与血脂异常/高胆固醇血症之间的关系的争议结果主要是由于高胆固醇饮食的质量、组成和给药时间以及在每项研究中使用的物种的差异造成的。因此,为了比较结果,必须考虑到可能改变研究结果的所有变量。

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