作者：赵慧1，程功2，梁宸源1，陈亮1，冯兴韬1，马甜甜1

单位：

1.710068陕西省西安市，西安医学院　2.710068陕西省西安市，陕西省人民医院心血管内二科

关键词：

　冠心病；冠状动脉微血管疾病；治疗；综述

Keywords：

Coronary disease; Coronary microvascular disease; Therapy; Review

CLC：

DOI：

10.12114/j.issn.1008-5971.2024.00.049

Funds：

陕西省自然科学基金资助项目（2022JQ-891）；陕西省中医药管理局项目（2021-ZZ-ZY003）；陕西省人民医院科 技创新领军人才项目（2022LJ-04）

摘要：

缺血性心脏病仍然是世界范围内死亡和残疾的主要原因之一。心绞痛和呼吸困难是缺血性心脏病患者 常见的就诊原因，但大多数患者行冠状动脉CT血管造影或冠状动脉造影检查并未发现阻塞性冠状动脉疾病，这些患者 中大部分以冠状动脉微血管疾病（CMVD）为主要诊断，而CMVD与不良心血管事件密切相关，且其发病机制复杂、 诊断困难、缺乏有效的治疗方案。近年来，冠状动脉功能学评估手段不断发展，CMVD被越来越多学者所重视，相关 研究也取得了巨大进展。本文对CMVD的病理生理机制、评估手段及治疗方法的最新研究进展进行综述，以期指导临 床工作。

Abstract：

Ischemic heart disease remains one of the leading causes of death and disability worldwide. Angina pectoris and dyspnea are common causes of patients with ischemic heart disease, but most patients do not have obstructive coronary artery disease on coronary CT angiography or coronary angiography, and most of these patients are primarily diagnosed with coronary microvascular disease (CMVD) , while CMVD is closely associated with adverse cardiovascular events, and its pathogenesis is complex, diagnosis and treatment are difficult, and specific treatment options are lacking. In recent years, the methods of coronary artery function assessment have been continuously developed, and CMVD has been paid attention to by more and more experts and scholars, and great progress has been made in related research. Therefore, this article will focus on a systematic review of the pathophysiology, evaluation methods and treatment methods of CMVD, in order to guide clinical work.

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