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对特殊类型心肌缺血的研究表明,冠心病患者的预后与运动耐量实验过程中心电图ST段压低程度呈显著负相关,而与是否出现疼痛症状无关。心肌缺血不是一个“全或无”的过程,缺血后仍存活的心肌细胞将显示一种相对持久的功能改变,包括两种状态,一是心肌顿抑,二是心肌冬眠,二者均可引起左心室功能障碍,且在一定条件下可互相转变。缺血预调对再灌注心肌是一个强有力的保护措施。大量研究结果表明,缺血预调过程中释放的内源性腺苷通过激活腺苷A1受体起动预调作用,而后者则触发一系列细胞内改变, 在随后的缺血过程中起保护作用。
The study of special type of myocardial ischemia showed that the prognosis of patients with coronary heart disease and exercise tolerance during the ECG ST segment depression was significantly negatively correlated with the presence or absence of pain symptoms. Myocardial ischemia is not an “all or nothing” process. Cardiomyocytes that survive ischemia will show a relatively long-lasting functional change, including two states, one with stunned myocardium and the other with hibernating myocardium, both of which Can cause left ventricular dysfunction, and under certain conditions can change each other. Ischemic preconditioning is a powerful protective measure against reperfusion of the myocardium. Numerous studies have shown that endogenous adenosine released during ischemic preconditioning is preconditioned by activation of adenosine A1 receptor, whereas the latter triggers a series of intracellular changes that play a protective role in subsequent ischemic events.