几种常见冠状动脉微循环病变的临床特点及机制研究进展

Progress in Clinical Characteristics and Pathogenesis of Several Coronary Microvascular Diseases

对心肌缺血患者冠脉大血管阻塞性病变的关注已成为临床常规,然而不少患者无大血管病变,或在大血管病变解除后,仍存在缺血症状和体征,对冠脉微循环的研究或将成为治疗该类患者的突破口。冠状动脉微血管疾病(CMVD)存在发病率高、病因复杂、表现多样、识别困难等问题,本文旨在综述心脏X综合征、冠脉慢血流现象(CSFP)、女性冠心病及冠脉无复流现象等常见CMVD的临床特点及病理机制的研究进展,为进一步鉴别诊断和有效治疗提供参考。

Concerns about coronary vascular obstructive disease in patients with myocardial ischemia have become clinical routine,however,many patients have no macrovascular disease,or after the relief of large vascular disease,there are still ischemic symptoms and signs.The study of coronary microcirculation may be a breakthrough in the treatment of these patients.Coronary microvascular disease（CMVD）is characterized by high incidence,complicated etiology,diverse clinical manifestations and difficulty in identification.This article aims to review clinical characteristics and pathological mechanism of common CMVD such as cardiac X syndrome,coronary slow flow phenomenon（CSFP）,female coronary heart disease and coronary no-reflow phenomenon,providing reference for further differential diagnosis and effective treatment.