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冠心病患者除有胸痛发作外,还有无症状性缺血发作。无症状性心肌缺血(SMI)的发生率很高,据统计,英国约有4～5百万这类患者;国内目前尚缺乏具体统计资料,但一般认为也不少见。SMI发作表现隐匿,易被临床忽视,病程中较易发生不稳定性心绞痛、心肌梗塞和猝死等心脏意外,因而受到临床重视。一、SMI及分型 SMI是指心肌灌注、功能和电活动的一种可逆性紊乱,引起心电图上ST段下移,而不伴有各种类型心绞痛,冠脉造影或病理检查有明显的冠脉狭窄。了解SMI的病理生理及发病机理,对发现病人及其防治具有重要意义。 Cohn将SMI分为三型。Ⅰ型:完全无自觉症状,但有心肌缺血证据,此型在健康中年人的发生率
In addition to chest pain in patients with coronary heart disease attacks, there are asymptomatic ischemic attacks. The incidence of asymptomatic myocardial ischemia (SMI) is very high. According to statistics, there are about 4 to 5 million such patients in the UK. There is currently no specific statistics in China, but it is generally considered not uncommon. SMI seizures show hidden, easily overlooked by the clinical course of the disease prone to unstable angina, myocardial infarction and sudden cardiac death and other accidents, which received clinical attention. First, SMI and classification SMI refers to a reversible disorder of myocardial perfusion, function and electrical activity, causing the ST segment on the ECG to move down without being associated with various types of angina pectoris, coronary angiography or pathological examination obvious crown Stenosis. Knowing the pathophysiology and pathogenesis of SMI is of great importance to discovering patients and their prevention and treatment. Cohn divides the SMI into three types. Type I: completely without symptoms, but there is evidence of myocardial ischemia, this type of middle-aged people in the incidence of health