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心肌缺血再灌注损伤中炎症反应的机制及治疗研究进展。

Research Progress on The Mechanism and Treatment of Inflammatory Response in Myocardial Ischemia-Reperfusion Injury.

机构信息

Department of Cardiology, The First College of Clinical Medical Science, China Three Gorges University, Yichang 443000, China.

Institute of Cardiovascular Diseases, China Three Gorges University, Yichang 443000, China.

出版信息

Heart Surg Forum. 2022 Jun 23;25(3):E462-E468. doi: 10.1532/hsf.4725.

Abstract

Acute myocardial infarction can be treated aggressively with intravenous thrombolysis, percutaneous coronary intervention, and coronary artery bypass grafting; however, recanalization can cause myocardial ischemia-reperfusion injury (MIRI). This is an important reason that restricts the treatment effect of patients. After the ischemic myocardium is restored to perfusion, an inflammatory response can occur within minutes and peak within a few days. Many pro-inflammatory cytokines can seriously damage cardiac function. Inflammation can regulate cardiomyocyte apoptosis, autophagy, pyroptosis, and necrosis, and is the main initiating factor leading to MIRI in cardiomyocytes. This article reviews the mechanism of inflammatory response in the ischemia-reperfusion period after acute myocardial infarction and the clinical value and application prospect of inhibiting inflammatory response in the treatment of acute myocardial infarction.

摘要

急性心肌梗死可以通过静脉溶栓、经皮冠状动脉介入治疗和冠状动脉旁路移植术进行积极治疗;然而,再通可能导致心肌缺血再灌注损伤(MIRI)。这是限制患者治疗效果的一个重要原因。在缺血心肌恢复灌注后,几分钟内即可发生炎症反应,并在数天内达到高峰。许多促炎细胞因子可严重损害心功能。炎症可以调节心肌细胞凋亡、自噬、细胞焦亡和坏死,是导致心肌细胞 MIRI 的主要起始因素。本文综述了急性心肌梗死后缺血再灌注期炎症反应的发生机制及抑制炎症反应在急性心肌梗死治疗中的临床价值和应用前景。

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