冠状动脉无复流现象的研究进展

Research progress of coronary no-reflow phenomenon

再灌注治疗是急性心肌梗死(AMI)最重要的治疗方法之一,然而有部分患者在心外膜梗阻解除的情况下,心肌组织仍然呈低灌注状态,这一现象被称为"无复流"。无复流的确切机制至今尚不清楚,大量研究表明有多种可能的机制导致无复流的发生,主要机制有内皮细胞损伤、中性粒细胞聚集及氧自由基释放。发生无复流的患者预后常常较差,目前尚无治疗无复流的标准方法,主要治疗方法有药物治疗、血栓抽吸、远端保护装置及缺血预处理。本文将对介绍无复流的研究进展进行综述。

Reperfusion therapy is one of the most important treatments for acute myocardial infarction （AMI）. In some case, obstruction of vascular epicardium is relieved, whereas myocardial tissue hypoperfusion remains. This phenomenon is called ＂no-reflow＂ whose exact mechanism is still unclear. Many studies have shown that there are several possible mechanisms leading to the occurrence of no- reflow, among which are endothelial cell injury, neutrophil accumulation and release of oxygen free radicals. Prognosis of patients with no-reflow is often poor and there is no standard treatment for no-reflow. Drug therapy, thrombectomy, distal protection devices and ischemic preconditioning are the major therapeutic approaches. This review mainly describes the research progress of the no-reflow phenomenon.