急性心肌梗死以高死亡率、預(yù)后極差等特點(diǎn)嚴(yán)重威脅人類(lèi)生命健康，常以經(jīng)皮冠狀動(dòng)脈介入術(shù)恢復(fù)血供，治療的同時(shí)易出現(xiàn)心肌缺血再灌注損傷（MIRI）等嚴(yán)重并發(fā)癥。目前，臨床上關(guān)于MIRI發(fā)生機(jī)制及治療方法仍存在空缺，因此，積極探尋減輕MIRI的方法對(duì)維護(hù)人類(lèi)生命安全有重大意義。中藥的有效成分在MIRI治療方面有顯著療效，其中生物堿類(lèi)中藥單體可通過(guò)調(diào)控多種通路減輕MIRI，如嗎啡激活絲裂原活化蛋白激酶（MAPK）信號(hào)通路、胡椒堿激活磷脂酰肌醇3-激酶/蛋白激酶B（PI3K/Akt）信號(hào)通路、苦參堿激活缺氧誘導(dǎo)因子-1α（HIF-1α）信號(hào)通路、異蓮心堿激活核因子E2相關(guān)因子2/血紅素加氧酶1（Nrf2/HO-1）信號(hào)通路、α-玉柏堿抑制基質(zhì)金屬蛋白酶（MMP）信號(hào)通路等，以達(dá)到抑制細(xì)胞凋亡、細(xì)胞自噬、氧化應(yīng)激、炎癥反應(yīng)、線粒體損傷等作用。對(duì)生物堿類(lèi)中藥單體作用于多種信號(hào)通路治療MIRI的相關(guān)機(jī)制進(jìn)行綜述，為減緩MIRI的發(fā)生發(fā)展提供理論基礎(chǔ)。

Acute myocardial infarction is a serious threat to human life and health due to its high mortality and poor prognosis. Percutaneous coronary intervention is often used to restore blood supply. At the same time, it is prone to serious complications such as myocardial ischemia-reperfusion injury (MIRI). At present, the clinical mechanism and treatment of MIRI are still vacant. Therefore, it is of great significance to actively explore ways to reduce MIRI to maintain human life safety. The effective components of traditional Chinese medicine have a significant effect in the treatment of MIRI, and alkaloids can reduce MIRI by regulating multiple pathways, such as morphine activates mitogen-activated protein kinase (MAPK) signaling pathway, piperine activates phosphatidylinositol 3 kinase/kinase B (PI3K/Akt) signaling pathway, matrine activates hypoxia inducible factor-1α (HIF-1α) signaling pathway, isoliensinine activates nuclear factor erythroid 2 related factor 2/heme oxygenase 1 (Nrf2/HO-1) signaling pathway,α-obscurine inhibition matrix metalloproteinase (MMP) signaling pathway, etc. In order to inhibit apoptosis, autophagy, oxidative stress, inflammatory response, mitochondrial damage and so on. This article reviews the relevant mechanisms of alkaloid based traditional Chinese medicine monomers acting on multiple signaling pathways, and provides a theoretical basis for slowing down the occurrence and development of MIRI.

國(guó)家教育部產(chǎn)學(xué)合作協(xié)同育人項(xiàng)目（220904439201225）;國(guó)家級(jí)大學(xué)生創(chuàng)新創(chuàng)業(yè)訓(xùn)練計(jì)劃項(xiàng)目（S202312661006）;湖南中醫(yī)藥大學(xué)教學(xué)改革研究項(xiàng)目（2023-JG011）;湖南中醫(yī)藥大學(xué)-湖南中和大漢健康產(chǎn)業(yè)運(yùn)營(yíng)管理有限公司聯(lián)合基金項(xiàng)目（02）;湖南中醫(yī)藥大學(xué)本科生科研創(chuàng)新基金項(xiàng)目資助（2023BKS015）