冠状动脉痉挛的临床特征和发病机制

Clinical features and pathogenesis of coronary artery spasm

冠状动脉痉挛(coronary artery spasm,CAS)是指心外膜冠状动脉异常收缩导致心肌缺血。东亚CAS的发病率远高于欧美,但受条件限制,我国在此方面的研究并不全面,缺乏临床实践的指导。目前CAS的发病机制尚不完全明确,新近的研究表明CAS与血管内皮细胞结构和功能紊乱、血管平滑肌细胞的收缩反应性增高、自主神经功能障碍、遗传易感性密切相关。笔者综合国内外CAS资料,就其临床特征和发病机制作一综述。

Coronary artery spasm （CAS） is an abnormal contraction of an epicardial coronary artery resulting in myocardial ischemia and its incidence is relatively high in East Asia as compared with Europe and the United States. Restricted by condition, there is no comprehensive study and lack of clinical practice guidance in China. The pathogenesis of CAS is not all clear, and it shows that it is closely related to the structure and function disorder of vascular endothelial cells, high contraction reactivity of vascular smooth muscle cells, autonomic nerve dysfunction and genetic susceptibility. The author composites materials of CAS in China and abroad, and summarizes the clinical characteristics and pathogenesis of CAS.