2024 年第 11 期 第 19 卷

低氧辅助治疗在心肌梗死管理中的潜力研究进展

Potential research progress of adjuvant hypoxic therapy in the management of myocardial infarction

作者：焦玥淼1强桂芬2赵丽3阴赪茜1

英文作者：Jiao Yuemiao1 Qiang Guifen2 Zhao Li3 Yin Chengqian1

单位：1首都医科大学附属北京安贞医院心脏瓣膜病介入中心，北京100029；2中国医学科学院北京协和医学院药物研究所药物靶点研究与新药筛选北京市重点实验室，北京100050；3北京体育大学运动人体科学学院北京市运动机能评定与技术分析重点实验室，北京100084

英文单位：1Interventional Center of Valvular Heart Disease Beijing Anzhen Hospital Capital Medical University Beijing 100029 China; 2Beijing Key Laboratory of Drug Target and Screening Research Institute of Materia Medica Chinese Academy of Medical Sciences ＆ Peking Union Medical College Beijing 100050 China； 3School of Sport Science Beijing Sport University Beijing Key Laboratory of Sports Function Assessment and Technical Analysis Beijing 100084 China

关键词：心肌梗死；低氧治疗；氧疗；再灌注损伤；血管生成

英文关键词：Myocardialinfarction;Hypoxiatherapy;Oxygentherapy;Reperfusioninjury;Angiogenesis

• 摘要：

• 心肌梗死仍然是一个重大的公共卫生挑战，尽管在急性期治疗和长期管理方面已经取得了进步，但寻找创新疗法以提高效果，改善患者预后及生活质量的探索仍在继续。即使目前手术治疗已经相当成熟，心肌梗死患者术后并发症发生率仍然较高，这促使医学界开始寻求辅助治疗方案。氧疗在20世纪被视为心肌梗死治疗的基石，但新证据揭示其对正常氧饱和度患者效果有限且可能带来潜在不良反应，这一治疗方法已不推荐常规使用。低氧治疗因此成为一种备受期待的新兴方法。低氧辅助治疗是通过控制性、间歇性地将患者暴露于低氧环境，引发适应性反应，从而改善心肌的代谢功能，增强血管功能，并提升运动耐力。这一疗法潜在的机理涉及稳定低氧诱导因子、刺激血管生成以及减少氧化应激，从而抵御缺血损伤，促进心脏修复。总之，低氧辅助治疗为心肌梗死管理提供了一种前景广阔的新方法，但需要通过更多的研究来优化其应用，并确保其安全性和有效性。

• Myocardial infarction remains a major public health challenge, and despite advances in acute treatment and long-term management, the search for innovative therapies to enhance outcomes and improve patient outcomes and quality of life continues. Even though surgical treatment has been quite mature, the incidence of postoperative complications in patients with myocardial infarction is still high, which prompts the medical community to begin to seek adjuvant treatment options. Oxygen therapy was considered the cornerstone of the treatment of myocardial infarction in the 20th century, but emerging evidence has revealed its limited effectiveness and potential adverse effects in patients with normal oxygen saturation, and this approach is no longer recommended for routine use. Therefore, hypoxia therapy has become a highly anticipated emerging method. Hypoxic adjuvant therapy is to induce adaptive response by exposing patients to hypoxic environment in a controlled and intermittent manner, so as to improve myocardial metabolism, enhance vascular function, and improve exercise endurance. The underlying mechanisms of this therapy involve stabilizing hypoxia-inducible factors, stimulating angiogenesis, and reducing oxidative stress, thereby protecting against ischemic injury and promoting cardiac repair. In conclusion, adjuvant hypoxic therapy provides a promising new approach for the management of myocardial infarction, but more studies are needed to optimize its application and ensure its safety and efficacy.