冠状动脉介入治疗中的微循环栓塞及治疗

临床广泛应用的再灌注治疗评价指标主要针对的是心内膜下冠状动脉,近年来越来越多的证据表明,冠状动脉微循环在心肌的血供中起着重要作用。有些急性心肌梗死患者,虽然通过血流重建治疗使梗死相关冠状动脉开通,但由于相关的冠状动脉微循环出现微栓塞,使近远期心血管事件发生率和病死率增加;相反,另外一些急性心肌梗死患者虽然相关冠状动脉仍闭塞,但其灌注区的心肌微循环却可通过侧支循环得到灌注,预后良好。因此,如何预防及治疗再灌注中的微循环栓塞受到越来越多的临床医生的关注,预示着冠状动脉粥样硬化性心脏病的介入治疗进入了"后再灌注时代",即同样重视微循环灌注的时代。本文将回顾和展望微循环栓塞及其治疗。

Minicirculation Embolism of Aeteria Coronaria Interventional Therapy and Its Treatment

The reperfusion therapeutic review index in clinic mainly aim at endocardium aeteria coronaria,more and more evidence indicate that aeteria coronaria microcirculation has importance on myocardial blood supply.Some patients with acute myocardial infarction use blood current rebuilding treatment to cause infarction correlated aeteria coronaria open,but the cardiovascular incidence and fatality near or long term increase because the aeteria coronaria microcirculation occur microembolization;during other patien...