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从肠道菌群-线粒体稳态探讨心肌梗死后抑郁病机

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心肌梗死是一种常见的临床危重症,其病因在于冠状动脉粥样硬化引发冠脉狭窄,从而出现急性且持续的缺血缺氧,最终导致心肌坏死.心肌梗死患者因疾病疼痛、创伤性操作、担心疾病进展以及经济状况等多种因素影响,容易出现抑郁等不良情绪,影响临床疗效及预后.因此,探索心肌梗死后抑郁的机制以指导临床治疗是亟待解决的难点和热点.肠道菌群与线粒体动力学、自噬过度导致的线粒体稳态失衡是影响动脉粥样硬化斑块稳定的重要原因.中医药历史源远流长,治疗心肌梗死后抑郁疗效显著,中医"阳化气,阴成形"理论与现代医学机制中"肠道菌群-线粒体稳态"相契合,由此认识心肌梗死后抑郁的发病机制,调节肠道菌群以恢复线粒体稳态可能是临床治疗该病的新策略.
Exploring Pathogenesis of Depression after Myocardial Infarction from Perspective of Intestinal Flora-Mitochondrial Homeostasis
Myocardial infarction is a common clinical critical illness,the cause of which is coronary artery stenosis caused by coronary atherosclerosis,resulting in acute and continuous ischemia and hypoxia,which ultimately leads to myocardial necrosis.Myocardial in-farction patients are prone to depression and other adverse emotions due to various factors such as pain,traumatic operations,fear of dis-ease progression,and economic status,which affects clinical efficacy and prognosis.Therefore,exploring the mechanism of depression af-ter myocardial infarction to guide clinical treatment is a difficult and hot issue to be solved.Recent studies have found that imbalance of mitochondrial homeostasis due to intestinal flora and mitochondrial dynamics and excessive autophagy is an important cause of athero-sclerotic plaque stabilization.Traditional Chinese medicine(TCM)has a long history of significant efficacy in the treatment of post-in-farction depression,and its theory of"Yang transforming Qi and Yin shaping Body"is compatible with the modern medical mechanism of"intestinal flora-mitochondrial homeostasis",thus recognizing the pathogenesis of post-myocardial infarction depression,and regu-lating the intestinal flora to restore mitochondrial homeostasis may be the most important factor in the development of post-myocardial infarction depression.The regulation of intestinal flora to restore mitochondrial homeostasis may be a new strategy for clinical treatment.

myocardial infarctiondepressionintestinal flora-mitochondrial homeostasis"Yang transforming Qi and Yin shaping Body"

刘祥、施晓军、赵海滨

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北京中医药大学,北京 100029

北京中医药大学东方医院,北京 100071

心肌梗死 抑郁 肠道菌群-线粒体稳态 "阳化气,阴成形"

2025

中医学报
河南中医药大学,中华中医药学会

中医学报

影响因子:1.264
ISSN:1674-8999
年,卷(期):2025.40(1)