当前,缺血性心脏病(IHD)是世界主要死亡原因之一。IHD是指因冠状动脉不同程度的受阻引起冠状血流和心肌耗氧需求之间不平衡而导致的心肌损害,最终形成充血性心力衰竭。心脏缺血损伤后,非缺血部位的心肌出现心肌重构,如心肌间质纤维化和心肌肥厚。心肌的重构过程可使心脏功能进一步恶化,更容易诱发心律失常。微小RNA(microRNAs,miRNAs)是一类长约22个核苷酸的非编码小分子RNA,通过与靶蛋白mRNA 3’端非编码区的不完全互补结合,抑制靶mRNA转录后的表达。最近大量研究显示,miRNA在心脏病理、生理过程中发挥着重要的调控作用,尤其与心肌梗死和梗死后心脏重构的发生、发展密切相关。本文将从miRNAs在IHD中的调控作用进行阐述,并探讨以miRNAs为靶点改善IHD患者的临床转归。 Currently, ischemic heart disease (IHD) is one of the leading causes of death in the world. IHD refers to the myocardial damage caused by the imbalance between the coronary blood flow and the myocardial oxygen demand due to different degrees of coronary artery obstruction, and finally the formation of congestive heart failure. Myocardial remodeling occurs in non-ischemic myocardium after myocardial ischaemia, such as myocardial interstitial fibrosis and cardiac hypertrophy. Myocardial remodeling process can further deteriorate the heart function, more likely to induce arrhythmia. MicroRNAs (miRNAs) are a class of non-coding small RNAs about 22 nucleotides in length. They inhibit the transcription of target mRNA after they are not completely complementary to the 3 ’untranslated region of the target protein mRNA. Recently a large number of studies have shown that miRNA plays an important regulatory role in cardiac pathology and physiology, especially closely related to the occurrence and development of myocardial infarction and post-infarction cardiac remodeling. This article will elaborate on the regulatory role of miRNAs in IHD and to explore the clinical outcomes of miRNAs targeting IHD patients.