自发性冠状动脉夹层:药物还是再血管化?

Spontaneous coronary artery dissection: medicine or revascularization?

自发性冠状动脉夹层是一种比较罕见的心血管疾病,临床症状轻重不一,患者预后也有极大的差异。目前发病机制尚不清楚,研究发现主要危险因素有女性、围生期、结缔组织缺陷、胸部外伤、口服避孕药及可卡因等药物滥用等目前对于治疗方案仍有很大争议,尚没有统一的指导方案,治疗策略主要包括药物保守治疗和再血管化治疗。现报道3个病例,同时对既往病例及诊疗方案进行总结讨论,以期待更加规范有效的治疗方案。

Spontaneous coronary artery dissection is a rare cardiovascular disease; There are varying severity of clinical symptoms;prognosis of patients is also greatly different. However, the pathogenesis of this disease is not clear. The main risk factors are： female,perinatal, connective tissue defects, chest trauma, oral contraceptives and cocaine and others substance abuse. The treatment remains controversial, there is no unified guidelines, the current treatment strategies mainly include drug therapy and revascularization. 3 cases were reported as followed. At the same time, cases and previous disease are summarized and discussed, in the hope of finding more standardized effective treatments.