冠状动脉无复流与炎症反应的关系

冠状动脉持续闭塞后,通过溶栓疗法、冠状动脉旁路移植术、经皮冠状动脉介入治疗等的建立和推广,使急性阻塞的冠状动脉多能及时再通,缺血的心肌重新获得血液供应。但是,再灌注之后可能使原有的心肌缺血性损伤进一步加重,即发生心肌缺血再灌注损伤。研究表明,微血管损伤是心肌缺血再灌注损伤的重要发病机制之一。激活的血管内皮细胞和白细胞相互作用,对血液流变学、微血管口径及血管通透性的影响即产生冠状动脉无复流现象。冠状动脉无复流与炎症反应相关。白细胞,一些炎症细胞因子如白细胞介素-6、白细胞介素-8、白细胞介素-10和肿瘤坏死因子-α等,均参与了冠状动脉无复流过程且发挥了重要作用。

Relationship Between Cardiac No-flow Phenomenon and Inflammation Responses

In cases of prolonged occlusion the ischemia does result in some injury. The myocardium that has been injured can experience further damage in spite of the returned blood flow. This phenomenon is ischemia/reperfusion-injury (IRI). Some research has suggested that microvascular injury should be an important pathology. The interaction of microvascular endothelial cells and leukocytes could bring about the no-flow phenomenon which is related to inflammation responses. Leukocytes and a set of inflammatory cellu...