治疗性浅低温在急性心肌梗死中的应用进展  

Research progress of mild therapeutic hypothermia in acute myocardial infarction

作　　者：邓伟[1] 李依玲[1] 余树春[1] Deng Wei;Li Yi-ling;Yu Shu-chun(Department of Anesthesiology,the Second Affiliated Hospital of Nanchang University,Nanchang 330006,China)

机构地区：[1]南昌大学第二附属医院麻醉科,江西南昌330006

出　　处：《中国急救医学》2019年第3期290-294,共5页Chinese Journal of Critical Care Medicine

基　　金：国家自然科学基金资助项目(81760338);江西省自然科学基金资助项目(20171BAB205029).

摘　　要：治疗性浅低温(MTH)作为目前研究的热点,是继再灌注疗法后降低心肌缺血-再灌注损伤的新策略,其心脏保护作用已在众多缺血性实验模型(心脏骤停、中风和器官保存)中得到了证实。然而,随机临床对照试验未能证明MTH可减少急性心肌梗死(AMI)患者的心肌梗死面积,但临床试验的阴性结果不能忽视MTH的心脏保护作用。实验数据和临床数据之间的这种明显差异可能与应用MTH的时间窗有关。本文将对MTH的基本原理和过去研究的可能机制做一简要综述,介绍MTH在AMI患者中的临床应用有效方法、目前临床试验的教训和未来发展方向。As a hotspot of current research,mild therapeutic hypothermia(MTH)is considered as a new strategy to reduce myocardial ischemia/reperfusion injury after reperfusion therapeutics,and its cardioprotective effect has been confirmed in many ischemic experimental models(cardiac arrest,stroke and organ preservation).However,randomized clinical controlled trials have failed to demonstrate that MTH can reduce myocardial infarct size in patients with acute myocardial infarction(AMI).Nevertheless,the negative results of clinical trials cannot ignore the cardioprotective effects of MTH.This apparent discrepancy between experimental data and clinical data may be related to the window of MTH application.This article will give a brief overview of the basic principles of MTH and the possible mechanisms of previous studies,and introduce the effective methods of MTH clinical application in patients with AMI,lessons from current clinical trials and future development directions.

关 键 词：治疗性浅低温(MTH) 急性心肌梗死(AMI) 心脏保护作用 

分 类 号：R542.22[医药卫生—心血管疾病]