Schlaifer J D, Kerensky R A
University of Florida College of Medicine, Department of Medicine, Gainesville 32610, USA.
Clin Cardiol. 1997 Jul;20(7):602-6. doi: 10.1002/clc.4960200705.
Experimental animal studies have shown that repetitive brief coronary occlusions render the heart resistant to myocardial infarction from subsequent, more prolonged, coronary occlusions. This phenomenon in animal models has been called ischemic preconditioning. In a number of clinical scenarios, the second in a series of ischemic episodes appears to be less severe than the first, suggesting that ischemic preconditioning also occurs in humans. If the mediator of preconditioning could be identified, it is conceivable that this agent could be administered to patients with coronary artery disease as a myocardial protectant. However, the definite clinical relevance of this interesting experimental finding remains unknown. Unlike the case in animal models subjected to an abrupt occlusion, preconditioning is difficult to study in the clinical setting. This article reviews the findings and limitations of the relevant clinical studies looking for ischemic preconditioning in humans.
实验动物研究表明，重复性短暂冠状动脉闭塞可使心脏对随后更长时间的冠状动脉闭塞所导致的心肌梗死产生抗性。动物模型中的这种现象被称为缺血预处理。在许多临床情形中，一系列缺血发作中的第二次发作似乎不如第一次严重，这表明缺血预处理在人类中也会发生。如果能够确定预处理的介质，那么可以设想将这种制剂作为心肌保护剂给予冠状动脉疾病患者。然而，这一有趣的实验发现的确切临床相关性仍然未知。与动物模型中突然闭塞的情况不同，在临床环境中很难研究预处理。本文综述了在人类中寻找缺血预处理的相关临床研究的结果及局限性。
