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首页> 外文期刊>European journal of trauma: official publication of the European Trauma Society >Ischemia-Reperfusion Injury Pathophysiology and Clinical Implications
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Ischemia-Reperfusion Injury Pathophysiology and Clinical Implications

机译:缺血再灌注损伤的病理生理学及其临床意义

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摘要

The term ischemia-reperfusion injury describes the experimentally and clinically prevalent finding that tissue ischemia with inadequate oxygen supply followed by successful reperfusiorj initiates a wide and complex array of inflammatory responses that may both aggravate local injury as well as induce impairment of remote organ function. Conditions under which ischemia-reperfusion injury is encountered include the different forms of acute vascular occlusions (stroke, myocardial infarction, limb ischemia) with the respective reperfusion strategies (thrombolytic therapy, angioplasty, operative revascularization) but also routine surgical procedures (organ transplantation, free-tissue-transfer, cardiopulmonary bypass, vascular surgery) and major trauma/shock. Since the first recognition of ischemia-reperfusion injury during the 1970s, significant knowledge has accumulated and the purpose of this review is to present an overview over the current literature on the molecular and cellular basis of ischemia-reperfusion injury, to outline the clinical manifestations and to compile contemporary treatment and prevention strategies. Although the concept of reperfusion injury is still a matter of debate, it is corroborated by recent and ongoing clinical trials that demonstrated ischemic preconditioning, inhibition of sodium-hydrogen-exchange and administration of adenosine to be effective in attenuating ischemia-reperfusion injury.
机译:术语缺血再灌注损伤描述了在实验和临床上普遍存在的发现,即供氧不足并随后成功进行再灌注的组织缺血会引发一系列广泛而复杂的炎症反应,这些炎症反应可能会加重局部损伤并导致远端器官功能受损。遇到缺血-再灌注损伤的条件包括不同形式的急性血管阻塞(中风,心肌梗塞,肢体缺血),各自的再灌注策略(溶栓治疗,血管成形术,手术血运重建)以及常规外科手术(器官移植,免费-组织转移,体外循环,血管外科手术)和重大创伤/休克。自从1970年代首次认识到缺血再灌注损伤以来,积累了很多知识,而本综述的目的是就缺血再灌注损伤的分子和细胞基础对当前文献进行概述,以概述临床表现和编制当代治疗和预防策略。尽管再灌注损伤的概念仍是一个争论的话题,但最近和正在进行的临床试验证实了这一点,这些试验表明缺血预处理,抑制钠氢交换和腺苷的给药可有效减轻缺血再灌注损伤。

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