PCI术后心肌缺血再灌注损伤机制与保护治疗  

Mechanism and protecting therapy of the myocardial ischemia-reperfusion injury in PCI postoperation

作　　者：付艳东[1] 赵翠萍[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心血管内科,150000

出　　处：《新医学》2012年第6期351-355,共5页Journal of New Medicine

摘　　要：PCI术是冠状动脉粥样硬化性心脏病患者血流重建的重要方式,但临床研究显示PCI术后经常会有慢血流、无复流,再灌注心律失常,及心肌酶谱的升高,直接影响患者的预后。因此如何减少PCI术后心肌损伤是现今研究的重要内容。目前关于心肌缺血再灌注损伤的发病机制有许多假设和报道,主要与心肌再灌注时自由基生成增多、细胞内钙离子超载、心肌细胞能量代谢障碍、微血管损伤和粒细胞浸润以及心肌细胞的凋亡等作用有关。PCI围手术期可采用药物干预与非药物干预保护心肌。PCI is a major way of revascularization in patients with coronary atherosclerotic heart disease,but clinical observations show that slow flow,no-reflow,reperfusion arrhythmia,and the rise of myocardial enzymes are often found in PCI postoperative patients.Therefore,how to reduce the myocardial injury is an important part of the present researches.At present,there are many assumptions and reports about the pathogenesis of myocardial ischemia-reperfusion injury,mainly on the accumulation of oxygen free radicals,cellular Ca2＋ overload,disorder of myocardial energy metabolism,microvessel damage,granulocytic infiltration and myocardial cell apoptosis,et al.Therefore,medicine intervention and non-medicine intervention can be used to protect myocardium in PCI perioperative period.

关 键 词：心肌缺血 再灌注损伤 自由基 细胞凋亡 缺血预适应 

分 类 号：R541.4[医药卫生—心血管疾病]