冠脉微血管功能障碍与慢性炎性风湿病

Coronary microvascular dysfunction and chronic inflammatory rheumatoid diseases

慢性炎性风湿病（chronicinflammatoryrheumatoiddiseases，CIRD）包括类风湿关节炎（rheumatoidarthiritis，RA）、系统性红斑狼疮（systemiclupus，SLE）、系统性硬皮病（systemicsclerosis，SSC）是导致缺血性心脏病的重要危险因素，也是导致心血管发病率和死亡率增加的重要原因之一。即使没有梗阻性心外膜冠状动脉疾病，炎症也可影响CIRD患者冠脉微血管功能，促进心肌缺血和心血管事件的发生。了解CIRD与冠脉微血管功能障碍（coronarymicrovasculardysfunction，CMD）的分子机制对制定治疗目标至关重要。

Chronic inflammatory rheumatoid diseases （CIRD） such as rheumatoid arthritis, systemic lupus （SLE） erythematosus, and systemic sclerosis （ SSC ） are important risk factors for the development of is- chaemic heart disease and important sources leading to high cardiovascular morbidity and mortality. In patients affected by CIRD,inflammation can affect coronary microvaseular function and contribute to the development of myocardial ischemia and cardiovascular events, even in the absence of obstructive epieardial coronary artery dis- ease. Understanding the molecular mechanism that underlies the development of coronary microvascular dysfunc- tion （CMD） in CIRD is of fundamental importance for the identification of specific therapeutic targets. Here we review the pathogenesis, diagnosis, and treatment strategies of CMD in CIRD.