非阻塞性冠状动脉缺血中冠状动脉微循环功能障碍的临床研究现状

Clinical research status of coronary microvascular dysfunction in non-obstructive coronary arteries

冠状动脉微循环功能障碍(CMVD)已被证实是非阻塞性冠状动脉缺血(INOCA)患者心肌缺血的潜在机制。CMVD是指冠状动脉微循环结构或功能异常,致冠状动脉血流量及心肌灌注量不足,从而影响患者的生活质量及预后,与不良心血管事件增加有关。随着对冠状动脉微循环认识的加深及评估手段的发展,可早期对CMVD患者进行精确诊断、风险分层并制定个体化用药方案,能较大程度的缓解CMVD患者的症状、提高生活质量并改善患者长期预后,但目前关于CMVD的研究仍缺乏大样本的随机临床试验。本文旨在对CMVD的流行病学、危险因素、评估手段、诊断标准及治疗进行综述。

Coronary microvascular dysfunction(CMVD)has been confirmed as the potential mechanism of myocardial ischemia in the patients with non-obstructive coronary artery ischemia(INOCA).CMVD is defined as the abnormal structure or function of coronary microcirculation,resulting in insufficient coronary blood flow and myocardial perfusion,which affects the quality of life and prognosis of the patients,and is related to the increase of adverse cardiovascular events.With the further exploration of coronary microcirculation and the development of evaluation methods,early accurate diagnosis,risk stratification and individualized medication can be made for the patients,which can greatly alleviate the symptoms and improve the quality of life and improve the long-term prognosis of the patients.However,the current research about CMVD is still lack of large sample randomized clinical trials.This paper focus on the epidemiology,risk factors,evaluation methods,diagnostic criteria and treatment of CMVD.