Heim M, Nicolino-Peltier C, Metras D, Habib G, Kretmann B, Luccioni R, Bertault-Perez P
Service de médecine interne et endocrinologie, CHU Timone, Marseille.
Arch Mal Coeur Vaiss. 1992 Sep;85 Spec No 2:185-8.
Coronary artery disease in cardiac transplant recipients is the main cause of mortality after the first postoperative year. This atheroma has unique anatomical features with widespread infiltration of the intima by inflammatory cells. The different physiopathological hypotheses are analysed. Immunological processes are probably responsible, suggesting chronic rejection. The cytomegalovirus could be an inductive mechanism. The classical vascular risk factors probably play a role but their action is not as clear as that of immunological and viral factors. Hyperlipidaemia is a causative mechanism and the predisposing role of steroid therapy is also recognised. From the practical point of view, correction of the classical risk factors is the only available therapeutic possibility at present.
心脏移植受者的冠状动脉疾病是术后第一年之后的主要死亡原因。这种动脉粥样硬化具有独特的解剖学特征，内膜有炎症细胞广泛浸润。分析了不同的生理病理假说。免疫过程可能起作用，提示存在慢性排斥反应。巨细胞病毒可能是一种诱发机制。经典的血管危险因素可能起作用，但其作用不如免疫和病毒因素那么明确。高脂血症是一种致病机制，类固醇治疗的易患作用也得到认可。从实际角度来看，纠正经典危险因素是目前唯一可行的治疗方法。
