CAJ | 학술논문

肢体缺血预处理是通过将止血带以不同的压力捆绑上肢或下肢造成肢体的缺血再灌注，来减少冠状动脉血流异常引起的心肌损伤。肢体缺血预处理可能通过神经、体液途径导致心肌线粒体 ATP敏感性钾通道开放、线粒体通透性转换孔关闭，来对心肌产生保护效应。肢体缺血预处理的临床试验有不一致的结果。最近的试验表明其有心肌保护作用，在择期经皮冠状动脉介入术患者应用肢体缺血预处理可以减少支架植入术后肌钙蛋白的升高和介入后心肌梗死的发生率。现肢体缺血预处理在择期经皮冠状动脉介入术的应用需要多中心大规模的临床试验证实。
지체결혈예처리시통과장지혈대이불동적압력곤방상지혹하지조성지체적결혈재관주，래감소관상동맥혈류이상인기적심기손상。지체결혈예처리가능통과신경、체액도경도치심기선립체 ATP민감성갑통도개방、선립체통투성전환공관폐，래대심기산생보호효응。지체결혈예처리적림상시험유불일치적결과。최근적시험표명기유심기보호작용，재택기경피관상동맥개입술환자응용지체결혈예처리가이감소지가식입술후기개단백적승고화개입후심기경사적발생솔。현지체결혈예처리재택기경피관상동맥개입술적응용수요다중심대규모적림상시험증실。
Remote ischemic preconditioning( RIPC) is reducing the myocardium damage caused by interruption of coronary circulation by in ating a cuff on a limb, and following by reperfusion.RIPC involves activation of humoral or neural pathways that open mitochondrial ATP-sensitive potassium channels in the myocardium and close mitochondrial permeability transition pores, making cardiomyocytes less vul-nerable to ischemia-induced cell death.This cardioprotective mechanism is now being translated into clinical practice,whereas some trials have shown contradictory results.Recently published clinical studies have reported encouraging results with RIPC.At present, the use of RIPC in elective PCI seems particularly attractive due to dramatic reduction in post-PCI troponin release and incidence of MI 4a in patients undergoing elective coronary stent implantation.Large-scale multicenter clinical trials are needed to establish the role of RIPC in the current clinical practice.