糖尿病对心肌低氧诱导因子-1的影响及研究进展  

Effect of diabetes on myocardial hypoxia-inducible factor-1 and its research progress

作　　者：王佳琪 王海英 Wang Jiaqi;Wang Haiying(Department of Anesthesiology,Affiliated Hospital of Zunyi Medical University,Zunyi 563000,China)

机构地区：[1]遵义医科大学附属医院麻醉科,563000

出　　处：《国际医药卫生导报》2020年第5期648-652,共5页International Medicine and Health Guidance News

基　　金：遵义医学院附属医院院基金[院字(2016)29号];贵州省麻醉学研究生工作站[黔教研合GZZ字(2016)05]。

摘　　要：体外循环麻醉下心脏手术带来的心肌缺血再灌注损伤(Myocardial Ischemia Reperfusion Injury,MIRI)严重威胁着心血管疾病患者的生命安全,当患者合并糖尿病时,其心脏疾病治愈率相比未合并糖尿病人群大幅下降,术后并发症及病死率显著提升。应用缺血预处理及缺血后处理的方式可达到减轻MIRI的目的,低氧诱导因子-1(Hypoxy Inducible Factor-1,HIF-1)则为二者关键的分子。HIF-1是调控缺氧转录反应的主要核转录因子,它结合于低氧反应原件激活HIF-1信号通路,通过调控下游靶基因的表达,调节心脏血管的再生、能量代谢、抑制细胞凋亡、调节氧化应激等方式,减轻缺血缺氧对心肌的损伤。然而心肌在糖尿病的作用下,HIF-1信号传导通路受抑制,使其对心肌的保护作用消失。目前在动物实验中稳定HIF-1结构及基因工程的方法在心肌保护方面取得了一定的成效。Myocardial ischemia reperfusion injury(MIRI)caused by cardiac surgery under extracorporeal circulation anesthesia seriously threatens the life safety of patients with cardiovascular diseases.When patients with diabetes mellitus,the cure rate of heart diseases is significantly reduced compared with those without diabetes,and the incidence of postoperative complications and mortality are significantly increased.Application of ischemic preconditioning and ischemic postconditioning can reduce MIRI.Hypoxia inducible factor-1(HIF-1)is the key molecule of both.HIF-1 is a major nuclear transcription factor that regulates the hypoxic transcription response.It binds to hypoxic response elements to activate the HIF-1 signaling pathway,by regulating the expression of downstream target genes,it regulates the regeneration of cardiac blood vessels,energy metabolism,inhibits apoptosis,and regulates oxidative stress to alleviate the damage of ischemia and hypoxia on the myocardium.However,the HIF-1 signaling pathway under the action of diabetes is inhibited,making its protective effect on the myocardium disappear.The methods of stabilizing HIF-1 structure and genetic engineering in animal experiments have achieved certain results in terms of myocardial protection.

关 键 词：低氧诱导因子-1 心肌缺血再灌注损伤 糖尿病 心肌保护 

分 类 号：R54[医药卫生—心血管疾病]