冠状动脉无复流现象的研究进展  

Research advances in coronary no-reflow phenomenon

作　　者：刘玲梅[1] 张梅[2] 

机构地区：[1]天津医科大学,天津300070 [2]武警医学院附属医院,天津300162

出　　处：《中国心血管杂志》2007年第1期64-67,共4页Chinese Journal of Cardiovascular Medicine

摘　　要：无复流现象是指堵塞的心外膜动脉开放性重建后部分心肌组织不能灌注的现象。无复流可能妨碍梗死的愈合及药物输送至梗死区,并影响未来侧枝循环的形成。大面积的无复流预示着梗死的膨展和左心室的舒张功能下降。无复流现象可能是多因素造成的。内皮损伤,血小板,纤维蛋白原和白细胞堵塞,动脉粥样硬化性微栓塞均可导致无复流的发生。心肌对比超声及多普勒导丝等诊断技术的应用提高了无复流的检出率。血小板膜糖蛋白Ⅱb/Ⅲa受体抑制剂等药物治疗,低体温,缺血预处理及远端保护装置可减少无复流发生。The no-reflow phenomenon is the inability to perfuse a portion of the myoeardium after re-establishment of patency of a previously occluded epicardial coronaryartery. No-reflow may impede the ability of the infarct to heal and prevent delivery of pharmaceutical agents into the infarct zone and have effects in the formation of future collateral circulation. A large area of no reflow predicts worse infarct expansion and left ventrieular dilation. No-reflow phenomenon is likely multifactorial, endothelial damage, platelet, fibrin and leukocyte plugging may result in it. Application of diagnostic technique such as myocardial contrast echoeardiography and Doppler wire improved detection rate of no-reflow phenomenon. Pharmacological interventions such as platelet glycoprotein Ⅱ b/Ⅲ a receptor antagonism,hypothermia, ischernic conditioning and distal protector can reduce no-reflow.

关 键 词：无复流 再灌注 心肌梗死 

分 类 号：R543[医药卫生—心血管疾病]