脑卒中供者心脏的心肌损伤机制与临床研究进展  

Clinical research progress and mechanism on myocardial injury in hearts from donors with stroke

作　　者：王小文[1,2] 郑哲 黄洁 Wang Xiaowen;Zheng Zhe;Huang Jie(Department of Cardiothoracic Surgery,the First Affiliated Hospital of Chongqing Medical University,Chongqing 400016,China)

机构地区：[1]重庆医科大学附属第一医院心胸外科,重庆400016 [2]中国医学科学院阜外医院心脏外科 [3]中国医学科学院阜外医院心力衰竭与移植病房

出　　处：《器官移植》2023年第1期42-48,共7页Organ Transplantation

基　　金：国家重点研发计划项目(2016YFC1300900);创新工程-中国医学科学院临床与转化医学研究专项(2022-I2M-C&T-B-038)。

摘　　要：脑死亡供者心脏是目前心脏移植最主要的器官来源。脑死亡发生后会出现严重的血流动力学改变和一系列器官功能变化,进而造成组织器官的功能损害甚至丧失,尤其是心脏。神经系统和心血管系统的生理、病理生理之间存在密切联系和相互作用,脑卒中发生后,通过脑-心轴反应导致自主神经失调、神经内分泌紊乱和强烈而持续的炎症反应,引发交感风暴、儿茶酚胺风暴、炎症风暴等导致脑卒中所致心脏损伤。本文旨在对近年来有关脑卒中供者心脏心肌损伤的机制研究及其对心脏移植术后疗效和预后影响的相关研究进行综述,为临床实践和进一步研究提供参考。At present,the heart of donor from donation after brain death are the primary organ sources for heart transplantation.After brain death,severe hemodynamic changes and a series of organ functional changes will occur,thereby leading to the functional damage or even loss of tissues and organs,especially the heart.Intimate relationship and interaction have been found in the physiology and pathophysiology between nervous and cardiovascular systems.After stroke,autonomic nervous disorder,neuroendocrine disorder and intense and persistent inflammatory reaction could be caused by the brain-heart axis reaction,leading to stroke-induced cardiac injuries,such as sympathetic storm,catecholamine storm,inflammatory storm,etc.In this article,research progresses on the mechanism of myocardial injury in heart from donors with stroke and the effect on clinical efficacy and prognosis after heart transplantation were reviewed,aiming to provide reference for clinical practice and subsequent research.

关 键 词：脑卒中 心脏移植 脑死亡 冠状动脉粥样硬化性心病 心律失常 交感风暴 儿茶酚胺风暴 

分 类 号：R617[医药卫生—外科学] R722.151[医药卫生—临床医学] R541