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巨噬细胞在脓毒性心肌病发病机制和治疗中的研究进展

宁兴敏^1,2, 裴子坤³, 李仁琦², 彭巍², 梁郡⁴, 朱佳慧², 裴建明^2,*, 李军²

¹西北大学生命科学学院，西安 710069；²空军军医大学基础医学院生理与病理生理学教研室，西安 710032；³宁夏贺兰县人民医院，银川 750200；⁴西安电力中心医院检验科，西安 710032

摘要

脓毒性心肌病(sepsis-induced cardiomyopathy, SIC)是由脓毒症诱导的心肌功能障碍，显著提高脓毒症患者的死亡率，其致病机制极为复杂，目前尚无针对性的治疗方案。巨噬细胞(macrophage, MΦ)作为心脏最丰富的免疫细胞，由于其高度异质性，在SIC的发生、发展及修复过程中起着重要作用。基于此，本文系统综述了心脏MΦ 的来源与功能，并探讨了其参与SIC 发病机制的可能途径。同时，本文总结了通过靶向抑制炎性MΦ 趋化与募集、特异性调控MΦ 的炎性极化及代谢重编程以增强修复性MΦ 活性，从而减轻脓毒症后的心功能障碍和组织损伤的研究进展，为靶向MΦ 开展SIC 的预防及治疗提供了理论依据。

关键词： 脓毒性心肌病; 巨噬细胞; 炎症

Research advances in the role of macrophages in the pathogenesis and treatment of sepsis-induced cardiomyopathy

NING Xing-Min^1,2, PEI Zi-Kun³, LI Ren-Qi², PENG Wei², LIANG Jun⁴, ZHU Jia-Hui², PEI Jian-Ming^2,*, LI Jun²

¹School of Life Sciences, Northwestern University, Xi'an 710069, China；²Department of Physiology and Pathophysiology, School of Basic Medical Sciences, Air Force Medical University, Xi'an 710032, China；³People's Hospital of Helan County, Yinchuan 750200, China；⁴Clinical Laboratory of Xi'an Electric Power Central Hospital, Xi'an 710032, China

Abstract

Sepsis-induced cardiomyopathy (SIC) is a form of myocardial dysfunction induced by sepsis, which significantly increases mortality in septic patients. Its pathogenic mechanisms are highly complex, and there is currently no targeted treatment strategy. Macrophages (MΦ), as the most abundant immune cells in the heart, play an important role in the initiation, progression, and repair of SIC due to their high heterogeneity. Therefore, this review systematically summarizes the origin and function of cardiac MΦ and explores their potential pathways in the pathogenesis of SIC. Additionally, it highlights recent research advances in mitigating postseptic cardiac dysfunction and tissue damage by targeting the inhibition of inflammatory MΦ recruitment, specifically regulating MΦ inflammatory polarization and metabolic reprogramming, thus enhancing the activity of reparative MΦ. This review provides a theoretical basis for targeting MΦ in the prevention and treatment of SIC.

Key words: sepsis-induced cardiomyopathy; macrophages; inflammation

收稿日期：　　录用日期：

通讯作者：裴建明　　E-mail:

DOI: 10.13294/j.aps.2026.0032

引用本文：

宁兴敏, 裴子坤, 李仁琦, 彭巍, 梁郡, 朱佳慧, 裴建明, 李军. 巨噬细胞在脓毒性心肌病发病机制和治疗中的研究进展[J]. 生理学报 2026; 78 (2): 385-394.

NING Xing-Min, PEI Zi-Kun, LI Ren-Qi, PENG Wei, LIANG Jun, ZHU Jia-Hui, PEI Jian-Ming, LI Jun. Research advances in the role of macrophages in the pathogenesis and treatment of sepsis-induced cardiomyopathy. Acta Physiol Sin 2026; 78 (2): 385-394 (in Chinese with English abstract).