冠状动脉非阻塞性心肌梗死的病因及预后研究进展  

Advances in Etiology and Prognosis of Myocardial Infarction with Non-obstructive Coronary Arteries

作　　者：张依曼 黄宝涛[1] 时瑞娟 陈茂[1] ZHANG Yiman;HUANG Baotao;SHI Ruijuan;CHEN Mao(Department of Cardiology,West China Hospital,Sichuan University,Chengdu 610000,China)

机构地区：[1]四川大学华西医院心脏内科,四川省成都市610000

出　　处：《中国全科医学》2021年第2期132-137,153,共7页Chinese General Practice

基　　金：四川省科技厅重点研发项目(2019YFS0351)。

摘　　要：冠状动脉非阻塞性心肌梗死(MINOCA)是一种多病因的临床综合征,其发病率约占急性心肌梗死的5%~25%,近年来在临床上引起普遍关注。由于最新的心肌梗死定义发生了一定变化,使得MINOCA的病因分类也随之有所不同,并且受不同病因的影响,MINOCA患者的预后情况目前尚无定论。本文结合第四版心肌梗死全球统一定义及近年来国内外MINOCA的相关研究,进一步总结归纳了MINOCA的病因及诊断流程,并对其短期预后、中长期预后分别进行了分析阐述,建议诊断为MINOCA的患者应积极探索其潜在病因,以期针对性治疗改善患者预后,并希望未来开展进一步研究探索MINOCA不同的病因对预后的影响。Myocardial infarction with non-obstructive coronary arteries(MINOCA)is a syndrome with multiple causes,which accounts for 5%-25%of acute myocardial infarction and arouses widespread concern in clinical practice in recent years.As the global definition of myocardial infarction has changed,the etiology of MINOCA may have also changed.Meanwhile,the prognosis of MINOCA remains unclear due to the influence of different causes.In this review,according to the Fourth Universal Definition of Myocardial Infarction and recent accumulating evidence on MINOCA,the etiology and diagnostic algorithm of MINOCA were further summarized,and the short-term middle-term and long-term prognosis of MINOCA were analyzed.We suggested that patients diagnosed with MINOCA should be evaluated to uncover the potential cause as far as possible for improving the prognosis,and hoped that further research would be carried out to explore the impact of different causes on the prognosis of MINOCA.

关 键 词：心肌梗死 冠状动脉非阻塞性心肌梗死 病因 预后 

分 类 号：R542.22[医药卫生—心血管疾病]