David H
Zentralbl Allg Pathol. 1980;124(4):305-13.
Secondary lysosomes, such as lipofuscin, are found in considerable numbers in myocardial cells not only with growing age but at any stage of life after intoxications or as a result of congenital heart defects. In addition, lysosomal enzymes are also localized at the membranes of the sarcoplasmic reticulum and at the Golgi vesicles. During ischemia, these enzymes are being detached from the membranes. This, however, happens at a time when the cell has already been damaged irreversibly. Until now, no outflow of lysosomal enzymes from these cells with a following damage of so far unchanged cells has been observed and seems unlikely to happen in view of present-day research results. The primary event and the decisive factor of an ischemic myocardial damage are the ATP reduction which starts within several minutes and the mitochondrial changes connected with it which induce among other things the structural and functional membrane changes, too.
次级溶酶体，如脂褐素，不仅在心肌细胞中随着年龄的增长大量存在，而且在中毒后的生命任何阶段或先天性心脏缺陷的情况下也会出现。此外，溶酶体酶也定位于肌浆网膜和高尔基体小泡膜上。在缺血期间，这些酶会从膜上脱离。然而，这发生在细胞已经受到不可逆损伤的时候。到目前为止，尚未观察到溶酶体酶从这些细胞中流出并随后损伤迄今未改变的细胞，而且根据目前的研究结果，这种情况似乎不太可能发生。缺血性心肌损伤的主要事件和决定性因素是ATP的减少，这在几分钟内就开始了，以及与之相关的线粒体变化，这些变化进而也会引起膜的结构和功能变化。
