微血管病性冠心病的研究进展

Research advances in microvascular coronary heart disease

冠状动脉微循环障碍(CMVD)是存在心肌缺血症状和心电图表现但冠状动脉造影正常的患者的常见病因。研究发现,内皮功能紊乱、神经内分泌异常及慢性炎症是CMVD的主要发病原因。近年来研究了多种评估冠状动脉微循环功能的新型技术,且以尼可地尔为代表改善微血管功能的药物在CMVD的治疗中备受关注。本文根据冠状动脉微循环通过调节心肌血流量影响心脏结构和功能的特征,提出微血管病性冠心病这一概念,并就其发病机制及诊疗作一综述,旨在提高临床认知,帮助临床医师准确甄别及处理疾病。

Coronary microvascular dysfunction(CMVD)is a common cause of patients with myocardial ischemia symptom and ECG manifestation but normal coronary angiography.The studies have found that endothelial dysfunction,neuroendocrine abnormalities and chronic inflammation are the main pathogenesis of CMVD.A lot of new technologies have been developed recently to assess the coronary microvascular function.The drugs for improving microvascular function,represented by nicorandil,have attracted much attention in the treatment of CMVD.Based on the fact that coronary microcirculation affecting the structure and function of the heart by regulating myocardial blood flow,this review proposed the concept of coronary microvascular heart disease,and reviewed its pathogenesis,diagnosis and treatment,in order to improve clinical cognition and help physicians accurately identify and treat disease.