E第十三章缺血再灌注损伤.ppt

Ischemia-reperfusion Injury
(缺血再灌注损伤)
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Xiao Qian Chen (陈晓钎), .
Department of Pathophysiology
Tongji Medical College
Huazhong University of Science and Technology
Case Presentation
A 50-year-old man was admitted to the hospital with severe chest pain of 5 hours duration. Mental confusion and in acute dyspnea (呼吸困难).
HR: 110 beats/min, sinus
rhythm;
BP: 75/50 mmHg;
ECG: ST segment elevation,
V1-V6
LVEF: 31%
X-ray: gross pulmonary
edema
Improvement in breath
BP: 100/70 mmHg
LVEF: 38%
Temporary ventricular
tachycardia (心律不齐)
diuretic, tissue plasminogen activator
Balloon
angioplasty
Question: why tachycardia occurred after operation?
Ischemic Injury is enhanced during reperfusion
Reperfusion Injury
Oxygen paradox, calcium paradox, pH paradox
ponents
0 hr
Reperfusion
Ischemic Injury of Neurons
1 hr
2 hr
Ischemia
Time
Injury
Death
Injury Windows
Reperfusion
Reperfusion injury
Recover
Early reperfusion
Delayed reperfusion
Persistent
perfusion deficit
< 6 hr
24 hr
Causes and Conditions of Reperfusion Injury
Causes
Conditions
Recover from cardiac an transplantation
Lysing thrombi
Ischemia time
Branch circulation
Oxygen consumption
Temperature, Na+, pH, Ca2+