冠状动脉微循环障碍的研究进展

The progress of coronary microvascular dysfunction

冠状动脉微循环由微小冠状动脉构成,调节冠状动脉血流阻力,维持心肌细胞正常功能,其结构或功能异常可引起临床疾病,称为冠状动脉微循环障碍。目前检测微循环的方式有多种,但尚无一种检测手段可使冠状动脉微循环直接可视化,多是通过评估冠状动脉循环阻力或心肌灌注间接评价微血管功能。该病在临床上有多种类型,包括无冠状动脉大血管狭窄的心脏X综合征、合并冠心病或心肌病的冠状动脉微循环障碍、冠状动脉介入术或冠状动脉旁路移植术后的无再流现象。根据其发病机制,治疗冠状动脉微循环障碍的药物主要通过抗血小板聚集、解痉、改善内皮细胞功能等措施改善微循环功能不全。

Coronary microcirculation,which is composed of coronary microvascular,can regulate the blood flow resistance and maintain the normal function of myocardial cells.Its structural or functional abnormalities may lead to clinical disease,which is called coronary microvascular dysfunction.There are many methods to detect it,none of which can directly visualize the coronary microcirculation,mostly indirecdy evaluating microvascular function through assessing coronary circulation resistance or myocardial perfusion.It has multiple clinical phenotypes,including Cardiac Syndrome X without stenosis of epicardial coronary artery,microvascular dysfunction associated with coronary heart disease of cardiomyopathy,no reflow phenomenon after percutaneous coronary intervention or coronary artery bypass grafting.According to its pathogenesis,the treatment may aim at anti-platelet,spasmolysis,ameliorating the endothelial cell function etc,to improve the microcirculation function.