心肌缺血再灌注中的棘手问题及对策

被引:5
作者
芦殿香 [1 ]
吴海英 [2 ]
芦殿荣 [3 ]
龙启福 [1 ]
张树娜 [1 ]
贾瑛 [4 ]
王欣佩 [1 ]
格日力 [1 ]
机构
[1] 青海大学医学院
[2] 青海西州人民医院内科
[3] 中国中医科学院望京医院
[4] 青海省玉树州治多县妇幼保健院
关键词
心肌缺血; 再灌注; 损伤; 辅助治疗;
D O I
10.13422/j.cnki.syfjx.2011.12.086
中图分类号
R541.4 [冠状动脉(粥样)硬化性心脏病(冠心病)];
学科分类号
1002 ; 100201 ;
摘要
目的:探讨心肌缺血再灌注研究中的一些棘手问题,以及目前应对这些问题的主要临床辅助策略。方法:通过查阅近几年发表的有关心肌缺血再灌注研究的文献,分析该研究领域的研究现状。结果:再灌注是恢复缺血心肌血流供应的有效手段。研究发现,冠状动脉闭塞后60~90 min实施再灌注能够有效挽救缺血心肌。再灌注可以引起心律失常、微循环紊乱、受损心肌细胞死亡,导致再灌注损伤;而不利的心肌重塑则是急性心肌梗死患者主要的死亡原因之一。常规即时再灌注的实施、减轻再灌注损伤和防止不利的心肌重塑等是现在临床治疗面临的难题。采取预处理、活化再灌注损伤救援激酶、干细胞治疗等辅助措施有望解决这些难题。结论:心肌缺血再灌注虽是恢复缺血心肌血液供应最有效的手段之一,然而,再灌注引起的损伤及不利的重塑也是急需解决的难题,再灌注治疗联合辅助措施有望为解决这一问题带来突破。
引用
收藏
页码:245 / 248
页数:4
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