周玉文, 曹雪滨. 盐皮质激素受体介导的糖皮质激素对心血管影响的病理生理学机制[J]. 心脏杂志, 2012, 24(6): 780-783.
    引用本文: 周玉文, 曹雪滨. 盐皮质激素受体介导的糖皮质激素对心血管影响的病理生理学机制[J]. 心脏杂志, 2012, 24(6): 780-783.
    Pathophysiological mechanisms of mineralocorticoid receptor-mediated glucocorticoid effect on cardiovascular system[J]. Chinese Heart Journal, 2012, 24(6): 780-783.
    Citation: Pathophysiological mechanisms of mineralocorticoid receptor-mediated glucocorticoid effect on cardiovascular system[J]. Chinese Heart Journal, 2012, 24(6): 780-783.

    盐皮质激素受体介导的糖皮质激素对心血管影响的病理生理学机制

    Pathophysiological mechanisms of mineralocorticoid receptor-mediated glucocorticoid effect on cardiovascular system

    • 摘要: 糖皮质激素(GC)由肾上腺合成分泌,也可在心肌中合成。GC和盐皮质激素(MC)对盐皮质激素受体(MR)具有同等的亲和力。心血管中存在MR。GC可通过与MR结合作用于心血管系统。心脏中的GC远远高于血液循环。氧化应激可促进MR的激活,而激活的MR又可诱导氧化应激,并参与心肌纤维化、心脏重构,促进钙离子内流。血清GC水平的升高是慢性心衰患者死亡风险增长的独立预测因子,具有致动脉粥样硬化,促进高血压形成的作用。阻滞MR已经作为房颤上游治疗的主要原则被论及GC在一些局部组织中浓度的增高与心血管高危因素有关。

       

      Abstract: Glucocorticoid (GC) is synthesized by the adrenal gland or in cardiac muscles. GC and mineralocorticoids (MC) have the same affinity for the mineralocorticoid receptor (MR). GC can act on cardiovascular system through binding to MR. GC in the heart is much higher than in the blood. GC activation can be accelerated by oxidative stress, and activated MR can also induce oxidative stress and is involved in myocardial fibrosis, cardiac remodeling and acceleration of calcium ion flow. Elevated serum GC level is an independent prediction factor of increased mortality risk in patients with chronic heart failure. Blocking MR has been reported as one main principle of “upstream” treatment of atrial fibrillation (AF). Elevated GC concentration in some local tissues is a cardiovascular risk factor.

       

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