心脏X综合征的发病机制和治疗研究进展

【作者】 胡蓉；

【导师】 戴万亨；

【作者基本信息】 成都中医药大学 ， 中西医结合临床， 2005， 硕士

【摘要】 心脏X综合征(cardiac syndrome X,CSX)是一类具有典型劳累型心绞痛、运动应激试验阳性、冠状动脉造影结果正常的异质性症候群。目前,引起CSX病人心绞痛发作的机制尚未完全阐明。大量证据表明部分病人的心绞痛为短暂的心肌缺血所致。而冠脉微血管功能障碍导致冠脉血流储备降低可能是引起心肌缺血的主要原因。现认为冠脉微血管功能障碍可能与内皮功能异常、炎症反应、雌激素缺乏、胰岛素抵抗、冠脉微血管痉挛以及冠脉微血管的重塑等因素有关。另外,痛觉异常、精神心理障碍、自主神经功能失调也可能参与了CSX心绞痛症状的发作。长期随访发现该综合征病人的预后好,但因频繁发作心绞痛使其生活质量显著下降,所以对该类病人的治疗主要是改善其生活质量。针对CSX病人发病的潜在主要机制进行治疗是治疗的关键。 近年来,随着国内外许多基础研究和临床试验的开展,使我们对CSX的病理生理机制有了更深入的认识,从而也为我们临床制定更为有效的治疗策略提供了理论依据。本文通过对近年来关于CSX的文献进行总结,主要对CSX的发病机制、治疗等方面作一综述。更多还原

【Abstract】 Cardiac syndrome X encompasses heterogeneous groups of individuals who present with typical exertional angina pectoris, positive results during exercise and normal coronary arteries on angiography. Nowadays it remains unclear that the mechanisms are responsible for the episodes of angina pectoris in patients with cardiac syndrome X. A large number of clinical research show angina pectoris may be caused by transient myocardial ischemia. Reduced coronary blood flow reserve caused by coronary microvascular dysfunction is considered as the major reason of myocardial ischemia. And coronary microvascular dysfunction may be caused by endothelial dysfunction, low-grade systemic inflammation, estrogen deficiency, insulin resistance, abnormal coronary microvascular spasm, coronary microvascular remodeling and so on. Additional reasons such as abnormal pain perception, psychologic disorders and autonomic nervous systerm imbalance may contribute to the pathogenesis of angina pectoris in patients with cardiac syndrome X. Although prognosis of patients with cardiac syndrome X is good regarding survival, they have a severely impaired quality of life because of the frequent episodes of angina pectoris. As a result, treatment of cardiac syndrome X should be mainly directed towards improving quality of life. Understanding the mechanism underlying the condition is of vital importance for patient management.Recently the development of considerable basic and clinical research has resulted in further comprehension about the pathophysiological of cardiac syndrome X. It has supplied theoretic evidence for the therapeutic strategies more available. This review summarizes the new development of pathophysiological mechanisms and treatment of cardiac syndrome X and emphasizes the conception of tranditional Chinese Medicine to it.更多还原