摘要
心肌梗死后幸存心脏经历了以心肌纤维化为主要病理进程的连续性改变。早期梗死区域修复性纤维化能够减少梗死区的扩张,防止心室壁破裂;而后期过度的纤维化则会导致心室重构,影响心脏的收缩或舒张功能。心脏成纤维细胞在心肌纤维化过程中发生增殖,表型转化直至迁移,分泌胶原等一系列病理过程,是心肌梗死后心脏的核心病理变化。以TGF-β/SMAD为经典的细胞内信号转导是目前对成纤维细胞功能的主要认识。由于心肌纤维化在心肌梗死后不同阶段具有不同作用,以及越来越多纤维化病理过程的不断涌现,导致基于目前已发现的病理机制开发的药物较少。中医药具有多靶点、多途径、生物活性成分丰富的特征,使得中医药在治疗心肌梗死后纤维化过程中具有优势。
The surviving heart after myocardial infarction undergoes continuous changes with myocardial fibrosis as the main pathological process.In the earlier stage,the infarct area reparative fibrosis can reduce the expansion of the infarct area and prevent rupture of the ventricular wall.However,excessive fibrosis in the later stage will lead to ventricular remodeling and affect the systolic or diastolic function of the heart.A series of pathological processes such as proliferation,phenotype transformation,migration and collagen secretion of cardiac fibroblasts are the core pathological changes of the heart after myocardial infarction.At present,taking TGF-β/SMAD as the classical intracellular signal transduction is the main understanding of fibroblast function.As myocardial fibrosis has different effects in different stages after myocardial infarction,and more and more pathological processes of fibrosis are emerging,As a result,fewer drugs have been developed based on the pathologic mechanisms that have been discovered so far.Traditional Chinese medicine(TCM)has the characteristics of multi-target,multi-path and rich biological active ingredients,which makes it have advantages in the treatment of fibrosis after myocardial infarction.This paper is based on cardiac fibroblasts to explore the different roles and mechanisms of myocardial fibrosis after myocardial infarction,and to review the current research status of the study.
作者
段文莉
魏庆双
吴美平
DUAN Wenli;WEI Qingshuang;WU Meiping(Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200071,China;School of Acupuncture,Moxibustion and Tuina,Beijing University of Chinese Medicine,Beijing 102488,China)
出处
《世界中医药》
CAS
2020年第23期3698-3703,共6页
World Chinese Medicine
基金
国家自然科学基金项目(81673915,81973826)。
