关于缺血性心肌功能障碍

IF 0.2 Q4 MEDICINE, GENERAL & INTERNAL Byulleten Sibirskoy Meditsiny Pub Date : 2015-12-24 DOI:10.20538/1682-0363-2014-6-57-71
В. В. Калюжин, Александр Трофимович Тепляков, Инна Давидовна Беспалова, Е. В. Калюжина
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引用次数: 5

摘要

本综述的作者对已发表的缺血性心肌功能障碍问题的论文进行了分析。他们从“缺血”一词的定义开始(来源于两个希腊单词:isch ',意思是抑制,海马,意思是血液)——一种动脉血流不足以提供足够的氧气来阻止细胞内呼吸从有氧形式转变为无氧形式的状态。这一过程产生ATP的速率较低,导致细胞ATP减少,ADP随之升高,并最终抑制受影响心肌节段的收缩性和松弛性功能。但由于基本概念如此简单,缺血的后果却如此多样。缺血对心肌功能的影响在不同病人身上如此不均衡,几乎不可能找到两个相同的病例(如指纹的情况)。它取决于冠状动脉病变的无限多样性,再灌注(血流恢复的时间和完整性)和心肌的反应,显然,心肌的反应具有相当大的灵活性。缺血性心肌功能障碍包括许多离散状态,如心绞痛急性左心室衰竭、急性心肌梗死、缺血性心肌病、昏厥、冬眠、前适应和后适应。有广泛不同的潜在病理生理状态。这些状态中有几种可能共存。
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К ВОПРОСУ ОБ ИШЕМИЧЕСКОЙ ДИСФУНКЦИИ МИОКАРДА
The authors of the review have analyzed papers published on the problem of ischemic myocardial dysfunction. They begin with a definition of the term “ischemia” (derived from two Greek words:  isch ō , meaning to hold back, and haima, meaning blood) - a condition at which the arterial blood flow is insufficient to provide enough oxygen to prevent intracellular respiration from shifting from the aerobic to the anaerobic form. The poor rate of ATP generation from this process causes a decrease in cellular ATP, a concomitant rise in ADP, and ultimately, to depression inotropic (systolic) and lusitropic (diastolic) function of the affected segments of the myocardium. But with such simplicity of basic concepts, the consequences of ischemia so diverse. Influence of an ischemia on myocardial function so unequally at different patients, which is almost impossible to find two identical cases (as in the case of fingerprints). It depends on the infinite variety of lesions of coronary arteries, reperfusion (time and completeness of restoration of blood flow) and reactions of a myocardium which, apparently, has considerable flexibility in its response. Ischemic myocardial dysfunction includes a number of discrete states, such as acute left ventricular failure in angina, acute myocardial infarction, ischemic cardiomyopathy, stunning, hibernation, pre- and postconditioning. There are widely differing underlying pathophysiologic states. The possibility exists that several of these states can coexist.
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来源期刊
Byulleten Sibirskoy Meditsiny
Byulleten Sibirskoy Meditsiny MEDICINE, GENERAL & INTERNAL-
CiteScore
0.70
自引率
50.00%
发文量
102
审稿时长
8 weeks
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