冠状动脉无复流机制及预测的研究进展

Research Progress in Mechanism and Prediction of Coronary Artery No-Reflow Phenomenon

无复流现象(NRP)是经皮冠状动脉介入(PCI)治疗中常见的并发症之一,其发生的病理生理机制并未完全明确。主要与微循环功能障碍、心肌缺血再灌注损伤、远端血管栓塞、炎症细胞浸润及神经功能障碍等有关。NRP不仅影响介入手术的疗效,更是发生恶性心律失常、心力衰竭和心源性猝死等严重并发症的危险因素。目前对于NRP的预测尚无明确的指南,但可通过SYNTAX评分、中性粒细胞淋巴细胞比率、血红蛋白、炎症指标和心电图等预测NRP的发生。

No-reflow phenomenon(NRP)is one of common complications in percutaneous coronary intervention(PCI).The pathophysiological mechanism is not completely clear,though the current study suggests that it′s mainly related to microcirculatory dysfunction,myocardial ischemia-reperfusion injury,distal blood vessels embolization,inflammatory cell infiltration and neurological dysfunction.NRP not only affects the efficacy of PCI but also is an important cause of serious complications such as malignant arrhythmia,heart failure and sudden cardiac death.There is currently no clear guide to the prediction of NRP,but some studies have found that NRP can be predicted by SYNTAX score,neutrophil lymphocyte ratio,hemoglobin,inflammation index and electrocardiogram.