中国多学科微血管疾病诊断与治疗专家共识

Chinese Multidisciplinary Expert Consensus on the Clinical Diagnosis and Treatment of Microvascular Diseases

微血管疾病是由多种病因引起的,可累及全身多个系统的,以直径<500μm的小动脉、微动脉、微静脉和毛细血管的损伤——微血管密度、直径及功能改变,继发阻塞继而影响组织灌注为共同病生理特征的血管疾病综合征。临床微血管疾病主要包括冠状动脉微血管功能障碍、脑微血管疾病、慢性肾脏疾病、胰岛素抵抗相关疾病和病理性肥胖等。迄今国际上尚缺乏对于微血管疾病的统一定义、诊断标准及治疗对策。经过专家共识会议和文献回顾,本共识总结了微血管疾病发生的危险因素、病理机制及临床特征,并对不同微血管疾病的诊断流程和主要的治疗策略给出了建议。

Microvascular disease(MVD)is a multi-system related vasculopathy caused by a variety of etiologies.The common pathophysiological features of this syndrome include changes on density,diameter and function of microvessels,which could lead to subsequent vascular obstruction,and reduced tissue perfusion.The clinical diseases following the injuries of small arteries,arterioles,venules and capillaries with a diameter of less than 500μm include coronary microvascular dysfuntion,cerebral small vessel disease,chronic kidney disease,insulin resistance-related disease and pathological obesity.So far,there is still a lack of uniformed definitions,diagnostic criteria and treatment strategies for MVDs worldwide.Based on consensus derived from our expert meetings and literature reviewing,we issue this consensus by summarizing the risk factors,pathological mechanisms and clinical features of MVDs.Furthermore,this consensus provides recommendations for the diagnosis process and main therapeutic options to different MVDs.