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tlwr840n无线路由器设置(冠状动脉微循环疾病的研究现状)

冠状动脉,微循环,微血管tlwr840n无线路由器设置(冠状动脉微循环疾病的研究现状)

发布时间：2019-02-08加入收藏来源：互联网点击：

^[35]中，尼可地尔能显著减少缺血性心脏病患者的心血管死亡率，但对于CMVD的预后是否有改善还需要大规模前瞻性研究；(5)5型磷酸二酯酶抑制剂：此类药物通过释放NO舒张心血管平滑肌从而改善心绞痛症状。在一项小规模研究中，西地那非显著改善了INOCA患者的CFR^[36]，提示此类药物特别是长效制剂伐地那非治疗CMVD可能有效，但尚需进一步的研究。

PART 06

CMVD的流行病学与预后

一项纳入了1 439例患者的大型队列研究发现，64%的非阻塞性冠心病患者存在CMVD，但患病率在性别上无统计学差异(男性60%比女性66%)^[37]，这一结论与最近的一项对434例患者的研究一致，CMVD发病率较高，但性别之间无统计学差异(男性39.5%比女性36.6%)，并且在5年的随访中发现，女性发生主要不良心血管事件风险显著低于男性(1.1%比5.5%)^[38]。

目前CMVD的预后仍存在争议，有临床研究显示CMVD的患者预后良好^[39-40]，但也有研究报道CMVD与不良心血管事件风险增加相关^[2]。这可能是由于群体招募的异质性导致的，CMVD作为独立因素的作用没有得到适当的评估，因此CMVD患者的预后还需进一步研究。

PART 07

小结

CMVD是由冠状动脉微血管结构和(或)功能障碍导致的一类疾病，有着其特殊的发病机制和诊断流程。临床上对于排除心外膜冠状动脉有严重狭窄或痉挛，但仍有心绞痛发作的患者应重视对冠状动脉微循环功能评价，以进行有针对性的治疗。目前CMVD的治疗主要依赖危险因素的干预或治疗原发疾病，有限的药物治疗尚须研究证实。

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