西洋参茎叶总皂苷对高血压心肌纤维化的影响及机制  

Effect and mechanism of panax quinquefolius saponin on hypertensive myocardial fibrosis

作　　者：张姝 徐兰 董泽洋 严庆玲 朱边安 徐家宝 ZHANG Shu;XU Lan;DONG Zeyang;YAN Qingling;ZHU Bian’an;XU Jiabao

机构地区：[1]浙江中医药大学,浙江杭州310053

出　　处：《中医临床研究》2023年第9期5-9,共5页Clinical Journal Of Chinese Medicine

摘　　要：心血管疾病的致病因素包括高血压引起的心肌纤维化(Myocardial Fibrosis,MF)。当机体失去对受损心肌细胞修复的控制时发生的MF是一个炎症过程。由成纤维细胞分化而来的肌成纤维细胞进一步促成纤维化。高血压心肌纤维化是高血压性心脏病的重要环节,以细胞增殖、细胞外基质过度沉积为特征,是心脏损伤后心脏重构的特征之一。MF作为不可或缺的一环,对心室重构以及心肌重塑产生作用。高血压心肌纤维化作为心血管疾病发展至一定阶段的病理表现,发病机制复杂多样,其治疗与预后挑战性高。西洋参茎叶总皂苷有抗心肌缺血、抗氧化、降血糖及调血脂等功能,在防治心血管疾病方面尤为显著。文章介绍了西洋参茎叶总皂苷的药理活性和其对高血压心肌纤维化的影响,同时就西洋参茎叶总皂苷对高血压心肌纤维化的治疗机制进行阐述,可通过多种途径作用于MF,以抑制MF的发生、发展,包括转化生长因子-β通路、肾素-血管紧张素-醛固酮系统、基质金属蛋白酶与基质金属蛋白酶组织抑制因子、自噬反应以及炎症反应诸如肿瘤坏死因子超家族。临床效应和药理作用的发挥都依赖于此,以期为进一步研究西洋参茎叶总皂苷治疗高血压心肌纤维化的临床应用提供参考。Factors that contribute to cardiovascular disease include myocardial fibrosis caused by hypertension.Myocardial fibrosis,which occurs when the body loses control of the repair of damaged cardiomyocytes,is an inflammatory process.Myofibroblast differentiation from fibroblast further contributes to fibrosis.Hypertensive myocardial fibrosis is an important link in hypertensive heart disease.It is characterized by cell proliferation and excessive deposition of extracellular matrix,and is one of the characteristics of cardiac remodeling after cardiac injury.Myocardial fibrosis,as an indispensable link,plays a role in ventricular remodeling and myocardial remodeling.Hypertensive myocardial fibrosis,as a pathological manifestation in the development of cardiovascular diseases to a certain stage,has complex and diverse pathogenesis,and its treatment and prognosis are challenging.Panax quinquefolius saponin have the functions of anti-myocardial ischemia,anti-oxidation,lowering blood glucose and regulating blood lipid,which are especially significant in the prevention and treatment of cardiovascular diseases.In this paper,the pharmacological activity of panax quinquefolius saponin and its effects on hypertensive myocardial fibrosis are introduced.Meanwhile,the therapeutic mechanism of panax quinquefolius saponin on hypertensive myocardial fibrosis is expounded.It can act on myocardial fibrosis through various ways to inhibit the occurrence and development of myocardial fibrosis.These include transforming growth faction-βpathways,renin-angiotensin-aldosterone systems,matrix metalloproteinases and matrix metalloproteinase tissue inhibitors,autophagy responses,and inflammatory responses such as tumor necrosis factor superfamilies.Both the clinical and pharmacological effects are dependent on this,and the prospect is to provide a reference for further research on the clinical application of panax quinquefolius saponin in the treatment of hypertensive myocardial fibrosis.

关 键 词：西洋参茎叶总皂苷 高血压 心肌纤维化 作用机制 中医药治疗 

分 类 号：R544.1[医药卫生—心血管疾病]