Zhuravlev A S, Azarov A V, Semitko S P, Ioseliani D G
I. M. Sechenov First Moscow State Medical University (Sechenov University), Moscow.
Kardiologiia. 2021 Mar 6;61(2):99-105. doi: 10.18087/cardio.2021.2.n1175.
Despite successful and timely revascularization of the infarct-related artery, myocardial tissue remains underperfused in some patients. This condition is known as the no-reflow phenomenon, which is associated with a worse prognosis. The first part of the systematic review on no-reflow focuses on description of the no-reflow pathogenesis and predictors. This phenomenon has a complicated, multifactorial pathogenesis, including distal embolization, ischemic injury, reperfusion injury, and a component of individual predisposition. Meanwhile, this phenomenon undergoes spontaneous regression in some patients. Several studies have demonstrated the role of definite biomarkers and clinical indexes as risk predictors for no-reflow. The significance of each pathogenetic component of no-reflow is suggested to be different in different patients, which may warrant an individualized approach in the treatment.
尽管梗死相关动脉成功且及时地实现了血管再通，但部分患者的心肌组织仍灌注不足。这种情况被称为无复流现象，它与更差的预后相关。关于无复流的系统评价的第一部分聚焦于无复流发病机制及预测因素的描述。这种现象具有复杂的多因素发病机制，包括远端栓塞、缺血损伤、再灌注损伤以及个体易感性因素。同时，这种现象在一些患者中会自发消退。多项研究已经证实特定生物标志物和临床指标作为无复流风险预测因素的作用。无复流各发病机制组成部分的重要性在不同患者中可能有所不同，这或许需要在治疗中采取个体化方法。
