曾定尹-冠状动脉痉挛发病机制和临床研究进展PPT课件

eischemicepisodesinpatientswithvariantangina.urmostoftenfrommidnighttoearlymorning冠状动脉痉挛的血管内超声所见CAG:痉挛处血管影象正常或无明显狭窄(≤50%),可发生次全闭塞或完全闭塞IVUS:冠脉痉挛局部AS早期变化,少有钙化和纤维化NormalAtypicalchestpainExertionalanginaAnginaatrestRecentmyocardialinfarctOldmyocardialinfarctValvulardiseaseCardiomyopathyFrequencyofprovokedcoronaryarteryarterialspasmin1089patientsundergoingarteriographyFromMichelECirculation1982,Vol65No71299-1304AS59%CAS内皮损伤慢性炎症反应植物神经紊乱吸烟是冠状动脉痉挛最主要的后天危险因素血管痉挛的多因素回归分析慢性炎症与冠状动脉痉挛的关系Non-spasmgroup(n=87)spasmgroup(n=112)pvalueAge(years)64.4±1.264.5±1.00.9265Men34/8765/1120.0080BMI25.1±0.424.3±0.40.147Hypertension52/8652/1110.0576HDL-C110.6±2.9108.7±3.20.6562LDL197.4±3.4195.0±3.70.6418Hs-CRP(mg/L)0.5(0.2-7.8)1.2(0.2-9.0)0.00052≤(mg/L)14/8741/1120.00133≤(mg/L)9/8723/1120.0522LEF(%)74±0.972.5±0.90.2617