血小板-白细胞聚集体在缺血后适应减少心肌无复流中的作用研究

项目名称： 血小板-白细胞聚集体在缺血后适应减少心肌无复流中的作用研究

项目编号： No.81500271

项目类型： 青年科学基金项目

立项/批准年度： 2016

项目学科： 医药、卫生

项目作者： 董梅

作者单位： 青岛大学

项目金额： 17万元

中文摘要： 心肌无复流（No-reflow, NR）是急性心肌梗死患者冠脉介入治疗后的严重并发症，与主要不良心脏事件密切相关。炎症-血栓机制是心肌NR发生的重要机制，高表达的血小板-白细胞聚集体（Platelet-leukocyte aggregates, PLA）是体内炎症反应和血栓形成的敏感指标。目前关于PLA在心肌NR发生中的作用尚未见报道。缺血后适应（Ischemia Postcontioning, IPostC）能够减轻缺血再灌注损伤，减少NR的发生，但IPostC减少NR的机制尚不清楚。本课题以急性心肌梗死患者为研究对象，观察PLA在NR中的动态表达及对其临床预后的影响，构建心肌NR模型，观察IPostC对MAPK相关炎症信号通路的影响及其与PLA表达的关系。本课题试图证实IPostC通过激活MAPK相关炎症信号通路抑制PLA而减少NR的发生，既丰富NR理论又为防治NR提供新思路。

中文关键词： 血小板-白细胞聚集体；心肌无复流；缺血后适应；炎症-血栓机制；急性心肌梗死

英文摘要： Myocardial no-reflow (NR) is a severe complication of coronary intervention in patients with acute myocardial infarction (AMI) and is associated with the major adverse cardiac events (MACE). It has been reported that inflammatory-thrombosis mechanism plays an important role in the occurrence of NR. Elevated level of PLA (Platelet-leukocyte aggregates, PLA) was proved to be a new sensitive marker of inflammation reaction and thrombosis formation. Ischemia Postcontioning (IPostC) can extenuate ischemia-reperfusion injury and reduce NR. However, the mechanisms of IPostC reducing NR, to our knowledge, have not been reported. Our study observe the dynamic expression of PLA in the occurrence of NR in patients with AMI, and explore the effects of PLA on clinic prognosis, and meantime, build the in vivo animal model of myocardial NR, observe the effects of IPostC on MAPK inflammatory signal pathway and on expression of PLA. We try to confirm that IPostC can reduce the occurrence of NR in patients with AMI by inhibiting PLA expression, through activating MAPK inflammatory signal pathway. It will rich the theory of NR and wide the therapeutic methods of myocardial NR.

英文关键词： Platelet-leukocyte aggregates;Myocardial no-reflow;Ischemia postconditioning;Inflammatory-thrombosis mechanism;Acute myocardial infarction