摘要
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脉开通,但由于相关的冠脉微循环出现微栓塞,使近远期心血管事件发生率和死亡率增加;相反,另外一些急性心肌梗死患者虽然相关冠脉仍闭塞,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。因此越来越多的临床医生开始关注微循环的灌注,出现了一系列针对微循环的评价指标。但是目前的技术尚无法在人体内直接观察微血管,微血管血流的测定也非常复杂,现回顾和展望微循环灌注的检测手段以及应用。
The link between acute coronary syndromes and atherosclerotic plaque rupture of the epicardial coronary arteries during coronary interventions has been established. Through coronary angiography a relationship between the severity and extent of coronary artery disease （ CAD ） and survival has been demonstrated. Milder forms of plaque rupture with subsequent embolization of atherosclerotic and thrombotic debris into coronary microcirculation have also been recognized before. Also the clinical frequency and importance of coronary microembolization in the clinical setting has only recently been appreciated. This review summarizes the anatomy and the available clinical detection of coronary microembolization.
出处
《心血管病学进展》
CAS
2009年第1期36-40,共5页
Advances in Cardiovascular Diseases
关键词
经皮冠状动脉介入治疗
微循环灌注
冠脉血流储备
微栓塞
心肌声学造影
percutaneous coronary intervention
microcirculation
coronary flow reserve
microembolism
myocardial contrast echocardiography
