缺血性心脏病再认识

Rethinking of Ischemic Heart Disease

缺血性心脏病是一种常见的导致心肌缺血、缺氧甚至坏死的慢性非传染性疾病,严重地威胁着人群健康。既往认为,缺血性心脏病的发生主要与冠状动脉的功能或器质性改变所引起的冠状动脉血流和心肌需氧量之间的不平衡有关。近年来,随着各国学者对缺血性心脏病研究的不断深入,对该病的认识逐渐从"以冠状动脉狭窄为中心"到"心肌缺血为中心"转变,即缺血性心脏病的发生是冠状动脉狭窄、炎症反应、血小板和凝血功能亢进、血管痉挛、微血管功能异常和内皮功能障碍等多个因素共同作用的结果。现从发病机制、临床诊断和干预措施等多个方面就新近缺血性心脏病进展做一简要介绍。

Ischemic heart disease（ IHD） is a common chronic non-communicable disease that leads to myocardial ischemia,hypoxia and even necrosis,posing a serious threat to human health. It is believed previously that the occurrence of IHD is mainly related to imbalance between coronary blood flow and myocardial oxygen demand caused by functional or organic changes in coronary artery. In recent years,IHD research in various countries has been increased,and their awareness of the disease is gradually changed from＂the center of coronary artery stenosis＂to ＂the center of myocardial ischemia＂,meaning that the occurrence of IHD is the result of concurrent multiple factors such as coronary artery stenosis,inflammatory response,platelets and coagulation hyperthyroidism,vasospasm,microvascular dysfunction and endothelial dysfunction and more. This paper attempts to make a brief introduction of recent progress of IHD from many aspects of pathogenesis,clinical diagnosis and intervention measures.