Myocardial ischemia - reperfusion no-reflow mechanism and medical thinking in the_0.doc

 PAGE \* MERGEFORMAT 22 Myocardial ischemia / reperfusion no-reflow mechanism and medical thinking in the [Keywords:] myocardial ischemia / reperfusion; no-reflow phenomenon; collaterals; in medicine; Summary Myocardial ischemia / reperfusion (Ischemia / Reperfusion, I / R) has three major complications, namely, ventricular arrhythmia, myocardial suppression Dayton and no-reflow (NR), NR in which the incidence of long-term prognosis for patients is important significance. NR is acute myocardial infarction (Acute Myocardia Infarction, AMI) in patients with percutaneous coronary intervention (Percutaneous Coronary Intervention, PCI) or thrombolytic therapy, infarct related artery (Infarction Relative Artery, IRA) after reperfusion, excluding lesions of acute occlusion, thrombus, dissection, a high degree of stenosis, and other factors epicardial spasm, coronary blood flow before (TIMI flow 0 to 1), they dominated the regional myocardial perfusion without perfusion, or poor [ 1]. At present the mechanism of the phenomenon of NR is not entirely clear if the phenomenon of a clear mechanism of NR on the clinical use of drugs will have far-reaching guide to improving AMI cardiac function and long-term prognosis of patients has important clinical value. 1 Overview of myocardial no-reflow 1974, Kloner reperfusion after coronary occlusion in the animal model to observe that even the lifting of epicardial occlusion, myocardial perfusion is also little or no blood flow, this result is described as the phenomenon of .1985 NR on, Schofer initially NR dual-isotope scanning technique that has occurred in human AMI reperfusion In 1986, Bate report NR and infarction during coronary angiography in the abnormal arterial contrast agent prior to filling associated slow. Since then, Wilson (1989 年), Pomerantz (1991), Feld (1992 年), Piana (1994 年), Abbo (1995 年), Ito (1996) and the Giris (2000 years) and so has confirmed, NR phenomenon occurred in the AMI, thrombolysis, PT