冠状动脉非阻塞性心肌梗死的抗血小板治疗作用  

Role of Antiplatelet Therapy in Myocardial Infarction with Non-Obstructive Coronary Arteries

作　　者：徐蓉玮 王亚玲[2] XU Rongwei;WANG Yaling(Graduate School,Hebei North University,Zhangjiakou 075000,Hebei,China;Department of Cardiology,The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院研究生学院,河北张家口075000 [2]河北北方学院附属第一医院心血管内科,河北张家口075000

出　　处：《心血管病学进展》2022年第10期888-892,共5页Advances in Cardiovascular Diseases

摘　　要：冠状动脉非阻塞性心肌梗死(MINOCA)是一组异质性疾病,可由多种病因引起,表现为具有心肌梗死的临床证据,但冠状动脉造影显示冠状动脉正常或仅轻度狭窄(<50%)。目前医学界关于MINOCA患者的治疗尚未达成共识,仍建议按照阻塞性心肌梗死传统治疗方法进行抗血小板治疗。然而,血小板在MINOCA中的病理生理学机制尚不完全明确,抗血小板治疗对MINOCA患者的作用存在争议。现评估抗血小板治疗在MINOCA患者不同病理生理机制下的作用,重点从潜在病理生理机制、当前抗血小板治疗证据、未来研究建议等方面进行阐述。Myocardial infarction with non-obstructive coronary arteries(MINOCA)is a heterogeneous group of diseases which has multiple etiologies and presents with clinical evidence of myocardial infarction,but coronary angiography shows that coronary arteries are normal or only have mild stenosis(<50%).At present,the medical community has not reached a consensus on the treatment of MINOCA patients,and it is still recommended to carry out antiplatelet therapy according to the traditional treatment methods of obstructive myocardial infarction.However,the role of platelets in the pathophysiology of MINOCA patients is not fully defined,and the role of antiplatelet therapy in MINOCA patients is controversial.This review will evaluate the role of antiplatelet therapy under different pathophysiological mechanisms in MINOCA patients,focusing on the underlying pathophysiological mechanisms,current evidence in antiplatelet therapy,and recommendations of future research.

关 键 词：抗血小板治疗 冠状动脉非阻塞性心肌梗死 粥样斑块 自发性冠状动脉夹层 微循环障碍 

分 类 号：R542.22[医药卫生—心血管疾病]