摘要
急性心肌梗死是冠状动脉粥样硬化性心脏病的一种类型,大多是由于冠状动脉狭窄闭塞,发生冠状动脉血供减少甚至中断,使供氧不足的心肌细胞发生严重持久的缺血坏死,导致心肌细胞代谢紊乱、脂质沉积,引起炎症因子表达升高,触发细胞凋亡,导致大量心肌细胞被吞噬降解,心功能急剧恶化。近年来研究发现,生长分化因子15(GDF-15)在急性心肌梗死后缺血缺氧的心肌细胞中呈高表达状态,这可能是一种对受损心功能的保护性应答反应。GDF-15可抑制细胞凋亡、缓解细胞损伤、调控脂质代谢、稳定斑块、减轻炎症反应、改善心肌缺血、减轻心肌梗死面积的持续扩大、促进内皮细胞增殖及血管新生。本文通过阐述急性心肌梗死后GDF-15对心血管系统的保护作用,进一步论证GDF-15在心血管疾病尤其是心肌梗死的发生发展中起到的作用及临床意义。
Acute myocardium infarction(AMI),a type of coronary atherosclerotic heart disease,mainly results from the narrowing and occlusion of coronary arteries,with reduced or even interrupted coronary blood supply,resulting in severe and prolonged ischemic necrosis of cardiomyocytes deprived of oxygen,myocardial cell metabolic disorders and lipid deposition.It increases the expression of inflammatory factors,triggers cell apoptosis,and leads to the phagocytosis and degradation of a large number of myocardial cells,resulting in rapid deterioration of cardiac function.In recent years,it has been found that growth differentiation factor-15(GDF-15)is highly expressed in myocardial cells of ischemia and hypoxia after AMI,which may be a protective response to impaired cardiac function.GDF-15 can inhibit apoptosis,relieve cell damage,regulate lipid metabolism,stabilize plaque,reduce inflammatory response,improve myocardial ischemia,reduce the continuous expansion of myocardial infarction area,and promote endothelial cell proliferation and angiogenesis.In this paper,the protective effect of GDF-15 on the cardiovascular system after AMI is described,and the role and clinical significance of GDF-15 in the occurrence and development of cardiovascular diseases,especially myocardial infarction,are further demonstrated.
作者
宋哲
郭欣君
杜佩蓉
格日勒
杨丽云
赵颖超
Song Zhe;Guo Xinjun;Du Peirong;Gerile;Yang Liyun;Zhao Yingchao(Department of Cardiology,Inner Mongolia Autonomous Region People′s Hospital,Hohhot 010017,China;Graduate School of Baotou Medical College,Inner Mongolia University of Science&Technology,Baotou 014060,China)
出处
《中国医药》
2023年第12期1892-1896,共5页
China Medicine
基金
内蒙古自治区自然科学基金(2017MS08158)
内蒙古医科大学联合项目(YKD2022LH054)。
关键词
急性心肌梗死
生长分化因子15
细胞凋亡
脂质代谢
炎症反应
血管新生
Acute myocardial infarction
Growth differentiation factor-15
Apoptosis of cells
Lipid metabolism
Inflammatory response
New blood vessels