小肠缺血再灌注损伤机制的研究进展和防治策略  

Research Progress of Small Intestinal Ischemia-Reperfusion Injury Mechanism and Prevention Strategies

作　　者：丛若尘 何伯圣[1] CONG Ruochen;HE Bosheng(Department of Imaging,the Second Affiliated Hospital of Nantong University,Nantong 226001,China)

机构地区：[1]南通大学第二附属医院影像科,江苏南通226001

出　　处：《医学综述》2020年第14期2716-2721,2727,共7页Medical Recapitulate

基　　金：南通市第五期“226工程”科研资助立项项目(通委组发〔2017〕27);南通市卫生和计划生育委员会科研课题(QA2019007);南通市社会民生科技项目(MS22019013)。

摘　　要：缺血再灌注损伤是指在缺血的基础上恢复血供后,组织器官损伤程度反而加重的现象。由于小肠结构和血管分布的特点,小肠容易发生缺血再灌注损伤。小肠缺血再灌注损伤机制复杂,可能涉及线粒体损伤、自由基累积、钙超载、炎症反应以及细胞凋亡等多种因素。小肠缺血再灌注损伤在基础研究层面的预防和处理方法主要包括缺血预处理和缺血后处理以及补充能量、对抗氧自由基、降低白细胞黏附、抗上皮凋亡等方式。由于肠缺血早期症状不明显、缺乏特效药物等原因,肠缺血患者临床疗效不佳,目前临床上仍以预防和对症处理为主。因此只有对小肠缺血再灌注损伤发病机制进行深入研究,才能推动一系列技术的开发和应用。Ischemia-reperfusion injury refers to the phenomenon that the degree of tissue and organ damage increases after blood supply is restored on the basis of ischemia.Due to the characteristics of structure of the small intestine and its blood vessel distribution,small intestine is prone to ischemia-reperfusion damage.The mechanisms resulting in ischemia-reperfusion injury in the small intestine is complex,potentially involving many factors,such as mitochondrial damage,free radical accumulation,overload of calcium,inflammatory reaction,and cell apoptosis.The preventive measures on the basic research level mainly include ischemic pretreatment and ischemic post-treatment,such as replenishing energy,antagonizing oxygen free radicals,reducing leukocyte adhesion,anti-epithelial apoptosis,and so on.Because early symptoms of intestinal ischemia are not obvious and there are no specialized drug treatments,the clinical treatment effects of ischemia is not good.At present,prevention and symptomatic management are still the main clinical treatments.Therefore,it is necessary to study further the pathogenesis of small intestinal ischemia-reperfusion injury to promote the development and application of a series of technologies.

关 键 词：缺血再灌注损伤 小肠 线粒体损伤 氧自由基损伤 

分 类 号：R364.2[医药卫生—病理学]