精神应激性心肌缺血发病机制探讨

The pathogenesis of mental stress-induced myocardial ischemia: a review

目前关于精神应激性心肌缺血疾病的诊疗规范尚未建立。临床常见患者有症状,但是缺乏心肌缺血时刻的临床证据。随着围绕精神应激性心肌缺血和心血管不良结局密切相关主题的研究不断出现,冠状动脉微循环狭窄或冠状动脉微血管痉挛越来越引起重视。现以精神压力为切入点,分析精神应激性心肌缺血的发病情况和特点,从心肌炎症反应、血管收缩、内皮功能障碍、交感神经传导、遗传因素角度阐述其病理机制。

At present,diagnostic standards and treatment guidelines for mental stress-induced myocardial ischemia have not been established.Clinical symptoms are often seen in patients,but clinical evidence of myocardial ischemia is lacking.With increasing research closely related to mental stress-induced ischemia and adverse cardiovascular outcomes,more and more attention has been paid to coronary microcirculation in stenosis or coronary microvasospasm.With mental stress as a starting point,this article analyzes the incidence and characteristics of mental stress-induced myocardial ischemia and reviews its pathological mechanisms from the perspectives of myocardial inflammatory reaction,vasoconstriction,endothelial dysfunction,sympathetic nerve conduction and genetic factors.