生物材料在心脏再生修复过程中的应用  

Application of biomaterials in cardiac regeneration and repair

作　　者：吴学平 吕叶辉[1,2] WU Xueping;L Yehui(Department of Anatomy,Histology and Embryology,Shanghai University of Medicine&Health Sciences,Shanghai 201318,China;Institute of Wound Prevention and Treatment,Shanghai University of Medicine&Health Sciences,Shanghai 201318,China)

机构地区：[1]上海健康医学院人体解剖与组织胚胎学教研室,上海市201318 [2]上海健康医学院创面防治研究所,上海市201318

出　　处：《中国动脉硬化杂志》2024年第6期539-546,共8页Chinese Journal of Arteriosclerosis

基　　金：上海健康医学院师资百人库项目(2021);用于心肌梗死修复自组装纳米生物材料的研究(HXXM-20-08-002)。

摘　　要：心肌梗死是冠状动脉急性、持续性缺血缺氧所引起的心肌坏死,发病率和死亡率居高不下。虽然通过冠状动脉介入或溶栓药物等治疗手段恢复血供,能提高患者的生存率,但难以挽救梗死区丢失的心肌细胞,而成年哺乳动物心脏自身修复能力有限是造成心肌纤维化,最终进展为心力衰竭的主要因素。长期以来,已有的治疗手段难以逆转心肌梗死后的心力衰竭进程。细胞移植有望成为促进梗死修复与再生最有前景的治疗方法,由于缺血缺氧微环境导致移植后有限的干细胞存活和保留,结果不是很理想。而脱细胞生物材料以促进血管生成和减轻纤维化显示了临床前治疗潜力。该综述概述了各种脱细胞生物材料及通过微创的方式进行心外膜修复及心肌内注射促进心脏再生、改善心脏功能的利与弊,为将来利用脱细胞生物材料结合优化的药物促进心肌再生提供参考。Myocardial infarction is myocardial necrosis caused by acute and persistent ischemia and hypoxia of coronary artery,with high incidence rate and mortality.Although the recovery of blood supply through coronary intervention or thrombolytic drugs can improve the survival rate of patients,it is difficult to rescue the lost cardiomyocytes in the infarcted area,and the limited self repair ability of the adult mammalian heart is the main factor that causes myocardial fibrosis and eventually progresses to heart failure.For a long time,the existing treatment methods are difficult to reverse the process of heart failure after myocardial infarction.Cell transplantation is a promising therapeutic method to promote the repair and regeneration of infarcts.Due to the ischemia and hypoxia microenvironment,the limited survival and retention of stem cells after transplantation are not ideal.And acellular biomaterials promoting angiogenesis and reducing fibrosis show the potential of preclinical treatment.This paper summarizes the advantages and disadvantages of various acellular biomaterials,epicardial infarct repair and intramyocardial injection in a minimally invasive manner to promote cardiac regeneration and improve cardiac function,and to promote myocardial regeneration by combining acellular biomaterials with optimized drugs in the future for reference.

关 键 词：缺血性心脏病 脱细胞生物材料 心脏手术 心肌再生 血管生成 

分 类 号：R5[医药卫生—内科学]