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冠状动脉微循环障碍:非阻塞性冠心病潜在发病机制
张艳达1,隋汝杰2,赵健1,张如岗3,贺治青1,杨本钊1,袁帅1,梁春1,吴宗贵1*
0
(1. 海军军医大学(第二军医大学)长征医院心内科, 上海 200003;
2. 解放军32138部队卫生队, 保定 071000;
3. 解放军联勤保障部队960医院呼吸内科, 济南 250031
*通信作者)
摘要:
冠状动脉微循环障碍严重影响着人类健康,因心绞痛行冠状动脉造影检查的患者中非阻塞性冠心病较为常见。冠状动脉微循环障碍可能与非阻塞性冠心病患者心绞痛的发生密切相关,然而微血管性心绞痛与冠状动脉微循环障碍的关系尚不明确。本文就冠状动脉微循环障碍的主要危险因素(如糖尿病、炎症反应、衰老、性别等)、发病机制(内皮细胞功能紊乱、平滑肌细胞功能障碍等)和治疗手段的研究进展作一综述。
关键词:  冠状动脉微循环障碍  内皮细胞功能障碍  微血管性心绞痛  冠心病
DOI:10.16781/j.0258-879x.2020.03.0315
投稿时间:2019-07-21修订日期:2020-02-08
基金项目:国家自然科学基金(81473445,91539118,81611130092),上海市科学技术委员会优秀学术带头人计划(17XD1405000),上海市医学领军人才计划(LJRC2015-21),重大疑难疾病中西医临床协作试点项目[ZY (2018-2020)-FWTX-1102].
Coronary microvascular dysfunction: the potential mechanism of non-obstructive coronary artery disease
ZHANG Yan-da1,SUI Ru-jie2,ZHAO Jian1,ZHANG Ru-gang3,HE Zhi-qing1,YANG Ben-zhao1,YUAN Shuai1,LIANG Chun1,WU Zong-gui1*
(1. Department of Cardiology, Changzheng Hospital, Naval Medical University(Second Military Medical University), Shanghai 200003, China;
2. Health Service Team, No. 32138 Troop of PLA, Baoding 071000, Hebei, China;
3. Department of Respiratory Medicine, No. 960 Hospital of Logistic Support Forces of PLA, Jinan 250031, Shandong, China
*Corresponding author)
Abstract:
Coronary microvascular dysfunction (CMD) seriously affects human health. Non-obstructive coronary artery disease (NOCAD) is common in patients undergoing coronary angiography for angina. CMD may be closely related to the incidence of angina in NOCAD patients; however, the relationship between microvascular angina and CMD is still unclear. This review focuses on the main risk factors (diabetes mellitus, inflammation, aging, gender, etc.), pathogenesis (endothelial cell dysfunction, smooth muscle cell dysfunction, etc.) and treatment of CMD.
Key words:  coronary microvascular dysfunction  endothelial cell dysfunction  microvascular angina  coronary disease