亚低温心脏保护作用的应用进展  

Cardioprotective Effect of Mild Hypothermia

作　　者：周永胜[1] 王姝[1] 

机构地区：[1]哈尔滨医科大学附属第一医院心内科,黑龙江哈尔滨150001

出　　处：《心血管病学进展》2014年第6期672-676,共5页Advances in Cardiovascular Diseases

基　　金：黑龙江省卫生厅课题资助(2007_161);哈尔滨医科大学附属第一医院院基金(2007090)

摘　　要：低温疗法是一种将患者的体温降低到预期水平而达到治疗疾病目的的方法.亚低温即降低体温至32～35℃,可以有效地减少兔、狗、猪、鼠的心肌梗死面积.降温获益与缺血后降温开始时间直接相关.亚低温心脏保护作用不仅局限于减少梗死面积,它同时具有改善缺血后心脏功能,减少无复流、改善微循环灌注,最终起到改善心脏重构的作用.但在初步的临床试验中,低温治疗急性ST段抬高性心肌梗死患者的结果是令人失望的,这可能是因为不能达到有效地快速降温.新的、快速的降温方法的临床应用,及相应信号通路的模拟药物将为低温治疗应用于急诊治疗提供崭新的前景.现就亚低温治疗的心脏保护作用、治疗方法及并发症的防治做一综述.The hypothermia treatment is the method in which the body temperature is reduced to a predetermined level in order to treat specific diseases. Mild hypothermia, 32 -35℃, is very potent at reducing myocardial infarct size in rabbits, dogs, sheep, pigs and rats. The benefits of cooling are directly related to the time in which the treatment is started after ischemia. The cardioprotective effect of mild hypother- mia is not limited to the reduction of infarct size, but also improves cardiac function after ischemia, reducing no reflow, improving mierocircu-lation perfusion, and ultimately attenuating left ventricular remodeling. The preliminary clinical trials in patients with acute ST-segment eleva- tion myocardial infarction were disappointing, possibly because cooling cannot be achieved rapidly. New approaches to induce a rapid cooling, and pharmacological mimicry of the protection provided by cooling, have recently been described and may soon be available for clinical use. This review looks at the cardioprotection provided by mild hypothermia, cooling methods, and the prevention for complications.

关 键 词：低温 心脏保护 并发症 

分 类 号：R454.5[医药卫生—治疗学]