急性心肌梗死经皮冠状动脉介入治疗后微血管阻塞的研究进展  

Research progress of microvascular obstruction after percutaneous coronary intervention in acute myocardial infarction

作　　者：杜明亮 王泊然 孙仕泽 孙丽丽[1] 何俊莹 李雪[1] 江淼 惠慧 DU Mingliang;WANG Boran;SUN Shize;SUN Lili;HE Junying;LI Xue;JIANG Miao;HUI Hui(Department of Coronary Heart Disease,Central Hospital of Dalian University of Technology,Liaoning Province,Dalian116032,China;Medical Record Room,Central Hospital of Dalian University of Technology,Liaoning Province,Dalian116032,China)

机构地区：[1]大连理工大学附属中心医院冠心病科,辽宁大连116032 [2]大连理工大学附属中心医院病案室,辽宁大连116032

出　　处：《中国医药导报》2024年第21期71-75,共5页China Medical Herald

基　　金：大连理工大学附属中心医院(大连市中心医院)“登峰计划”院内自主立项项目(2022ZZ228)。

摘　　要：约50%的急性心肌梗死患者伴有冠状动脉微血管阻塞(CMVO),这不仅弱化介入治疗的效果,而且增加了主要不良心血管事件。本文梳理了CMVO发病机制的研究新进展,包括血栓和粥样斑块碎片导致远端栓塞、微血管痉挛、内皮功能障碍、缺血和再灌注损伤等因素,以及超声心动图、心脏磁共振成像、正电子发射断层扫描技术、微血管阻力指数在CMVO诊断中的应用,并结合最新的循证依据对CMVO的中西医治疗及相关的靶点治疗进行简要综述,旨在加强临床医师对该疾病的认识和管理。Approximately 50%of patients suffering from acute myocardial infarction with coronary microvascular obstruction(CMVO),which not only diminishes the efficacy of interventional therapy but also elevates the occurrence of significant major adverse cardiovac events.This article provides an overview of the recent advancements in understanding the pathogenesis of CMVO,encompassing factors such as distal embolism due to thrombosis and plaque fragmentation,microvascular spasm,endothelial dysfunction,ischemia,and reperfusion injury.Additionally,it discusses the utilization of echocardiography,cardiascular magnetic resonance,positron emission tomography,and hyperemic microvascular resistance index for diagnosing CMVO.Furthermore,it offers a concise review of both Chinese and Western medical treatments as well as targeted therapies for CMVO based on current evidence-based medicine with the objective of enhancing clinicians’comprehension and management strategies for this condition.

关 键 词：急性心肌梗死 经皮冠状动脉介入治疗 微血管阻塞 

分 类 号：R542[医药卫生—心血管疾病]