摘要
新型冠状病毒肺炎(COVID-19)已迅速发展成全球卫生紧急事件。新型冠状病毒,即SARS-CoV-2,可影响多个器官,特别是肺脏和心脏。研究发现心脏生物标志物特别是超敏肌钙蛋白(hs-cTnI)和肌酸激酶(CK)的升高,在新型冠状病毒肺炎患者中很常见,有助于疾病诊断和危险分层。同时发现既往有心血管疾病的患者更易感染新型冠状病毒,其中高血压、心律失常、心肌病和冠心病是新型冠状病毒肺炎严重病例中常见的心血管疾病。如今越来越多的文献探讨了新型冠状病毒对心脏的影响,其中心肌损伤是新型冠状病毒肺炎的重要特征之一。但新型冠状病毒导致心肌损伤的确切机制尚不清楚。目前认为心肌损伤的机制包括病毒对心肌细胞的直接损伤、全身炎症反应、心肌纤维化、干扰素介导的免疫反应、1型和2型辅助性T细胞夸大的细胞因子反应、冠状动脉斑块失稳以及缺氧等。考虑到新型冠状病毒对心血管系统的复杂影响,我们需要进一步明确发病机制,以找到降低新型冠状病毒肺炎相关性急性心肌损伤发生率和死亡率的治疗方法。
COVID-19 has rapidly developed into a global health emergency.The COVID-19 virus,or SARS-CoV-2,can affect many organs,especially the lungs and heart.Studies have found that the elevation of cardiac biomarkers,especially high-sensitivity troponin I(hs-cTnI)and creatine kinase(CK),is very common in patients with COVID-19,which is helpful for disease diagnosis and risk stratification.At the same time,it was found that patients with previous cardiovascular diseases were more likely to be infected with SARS-CoV-2.Hypertension,arrhythmia,cardiomyopathy and coronary heart disease were common cardiovascular diseases in severe cases of COVID-19.Nowadays,more and more literatures have discussed the influence of SARS-CoV-2 on the heart,in which myocardial injury is one of the important characteristics of COVID-19.However,the exact mechanism of myocardial injury caused by SARS-CoV-2 remains unclear.At present,the mechanisms of myocardial injury include direct damage to cardiomyocytes by virus,systemic inflammatory response,myocardial fibrosis,interferon-mediated immune response,exaggerated cytokine response of type 1 and type 2 helper T cells,coronary plaque instability and hypoxia.Considering the complex effects of SARS-CoV-2 on the cardiovascular system,we need to further explore the pathogenesis in order to find better treatments that could reduce the incidence and mortality of COVID-19 related acute myocardial injury.
作者
宋双
孙大康
李洋
程艳丽
SONG Shuang;SUN Dakang;LI Yang;CHENG Yanli(Department of Cardiology,Binzhou Medical University Hospital,Binzhou 256603,China;Clinical Medicine Laboratory,Binzhou Medical University Hospital,Binzhou 256603,China)
出处
《药学研究》
CAS
2021年第4期239-243,277,共6页
Journal of Pharmaceutical Research
基金
山东省高等学校科技计划项目基金资助(No.J18KB117)。
