《2020年欧洲非阻塞性冠状动脉缺血疾病专家共识》解读——提高分级诊疗能力,加强全-专联合管理  

Interpretation of the Newly Released European Expert Consensus Document on Ischaemia with Non-Obstructive Coronary Arteries:Improving the Ability of Hierarchical Diagnosis and Treatment,and Strengthening the Joint Management of General Practitioners and Specialist Physicians

作　　者：黄宝涛[1] 陈茂[1] HUANG Baotao;CHEN Mao(Department of Cardiology,West China Hospital of Sichuan University,Chengdu 610041,China)

机构地区：[1]四川大学华西医院心脏内科,四川省成都市610041

出　　处：《中国全科医学》2021年第2期125-131,共7页Chinese General Practice

基　　金：四川省科技厅重点研发项目(2019YFS0351)。

摘　　要：非阻塞性冠状动脉缺血疾病(INOCA)是指具有可疑缺血相关症状,但经冠状动脉造影检查没有发现阻塞性冠状动脉狭窄(狭窄程度≥50%)的疾病。该疾病患者人群广泛而治疗不足。近日,欧洲经皮心血管介入学会(EAPCI)与欧洲心脏病学会(ESC)冠状动脉病理生理学和微循环工作组联合发布了《欧洲非阻塞性冠状动脉缺血疾病专家共识》。本文结合欧洲专家共识对INOCA的亚型、患病率、危险因素、病理生理学机制、临床特征、预后意义、无创及侵入性诊断方法、患者管理和药物治疗等内容进行解读,以期提高临床医生对这类患者的认识,使其重视对疾病亚型的分类,采取个体化的治疗策略,改善患者症状及预后,降低医疗消耗。Ischaemia with non-obstructive coronary arteries(INOCA)refers to a disease with suspected ischemic symptoms,while no obstructive coronary artery stenosis(stenosis degree≥50%)is found by coronary angiography.The disease is prevalent but individuals with INOCA are significantly undertreated.Recently,an EAPCI expert consensus document was released on ischaemia with non-obstructive coronary arteries in collaboration with European society of cardiology working group on coronary pathophysiology&microcirculation endorsed by coronary vasomotor disorders international study group.We interpreted the consensus document from the aspects of INOCA endotypes,epidemiology,risk factors,pathophysiology mechanism,clinical features,prognostic significance,noninvasive and invasive diagnostic methods,and patient management and medication,in order to raise awareness of clinicians for INOCA,prompt them to put a high value on INOCA endotypes and take tailored treatment,with the ultimate goals of improving angina symptoms and prognosis of patients with INOCA,and reducing medical cost.

关 键 词：冠状动脉疾病 微血管性心绞痛 冠状血管痉挛 心肌缺血 心绞痛 专家共识 解读 

分 类 号：R541.4[医药卫生—心血管疾病]