背景 虽然缺血预处理仍然是目前已知的最强大内源性心肌保护措施，但是因时机选择等原因其临床应用受到了极大的限制。大量动物实验证明，刺激迷走神经能够通过激活“胆碱能抗炎通路”、降低心肌交感神经兴奋性和抑制氧自由基的产生等作用机制，来减轻心肌缺血再灌注损伤（IRI）。另外，也有少数随机对照临床研究证实了迷走神经刺激的心肌保护作用。目的 本文的目的是评价迷走神经刺激对心肌IRI的保护作用。内容 本文就迷走神经刺激的发现、发展，心肌保护作用的机制及其临床应用价值进行了综述。趋向 这一现象的发现为降低心肌IRI提供了一个简单易行且费用低廉的措施。然而，在将迷走神经刺激推荐作为临床工作的常规措施之前，仍需进行更多大规模的临床研究，以评估和优化迷走神经刺激措施的保护作用。
Background The ischemia preconditioning is the most powerful endogenous cardioprotective intervention up to now，but its clinical application has been hampered by the requirement to intervene before the onset of acute myocardial ischemia. Many animal studies suggest that electrical stimulation of vagus never can reduce myocardial ischemia reperfusion injury by activating cholinegic anti-inflammatory pathway，lowering excitation of sympathetic nerves and inhibiting production of oxygen free radicals. Furthermore，small randomized trials in humans suggest that electrical stimulation of vagus never significantly reduces myocardial injury. Object Objects of this review are to evaluate the possible effect of electrical stimulation of vagus never on myocardial IRI. Content This article reviews the history and evolution of the electrical stimulation of vagus never conditioning，the potential mechanistic pathways underlying its cardioprotective effect，and its emerging application in the clinical setting. Trend Electrical stimulation of vagus never may represent a feasible and inexpensive method of reducing myocardium ischemic reperfusion injury. However，large-scale clinical trials to assess and optimize the effect of electrical stimulation of vagus never on mortality and morbidity are required before it can be recommended for routine clinical use.
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