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无症状性心肌缺血的最新认识简述如下。 (一) 定义:心肌氧供不能满足需求时发生心肌缺血。常见的原因是心外膜冠状动脉形成粥样硬化斑块,导致心肌灌注不足,有氧代谢转变为无氧代谢,心肌收缩减弱和电生理改变,但不一定伴有心绞痛。无症状性心肌缺血仅指不伴有胸痛的心肌缺血。心肌缺血时不出现症状的原因有三种假说,(1)缺血较轻,未达到痛阈;(2)疼痛的感受阈或疼痛刺激的向心传导有明显个体差异;(3)病理生理不同,导致不同类型的心肌血流障碍。 (二)标志:心肌灌注不足能用~(201)铊、正电子发射断层摄影剂~(82)铷或~(13)氮进行闪烁摄
The latest understanding of asymptomatic myocardial ischemia is summarized below. (A) Definition: myocardial ischemia can not meet the demand for myocardial ischemia. Common causes of epicardial coronary atherosclerotic plaque formation, resulting in myocardial perfusion, aerobic metabolism into anaerobic metabolism, decreased myocardial contractility and electrophysiological changes, but not necessarily associated with angina pectoris. Asymptomatic myocardial ischemia refers only to myocardial ischemia without chest pain. There are three hypotheses for why there are no signs of myocardial ischemia: (1) less ischemia and no pain threshold; (2) significant differences in centripetal transmission of pain threshold or pain; (3) pathophysiology Different lead to different types of myocardial blood flow disorders. (B) mark: Insufficient myocardial perfusion Blinking with ~ (201) thallium, positron emission tomography ~ (82) rubidium or ~ (13) nitrogen