瘦素抵抗与冠状动脉微循环障碍相关性的研究进展

摘要

约50%的冠状动脉疾病患者都有冠状动脉微循环障碍,许多证据显示冠状动脉微循环障碍患者有更显著的心血管不良事件的发生率,包括心力衰竭住院、心源性猝死、心肌梗死.冠状动脉微循环障碍可以单独出现,或者与阻塞性冠状动脉疾病一同存在.冠状动脉微循环障碍与传统心血管疾病存在相类似的危险因素,包括吸烟、糖尿病、衰老、高血压、高血脂及肥胖.正常生理条件下,瘦素通过平衡能量摄取与能量消耗来调节体重.有些研究表明高水平的血浆瘦素与冠状动脉粥样硬化、心肌梗死、卒中和冠状动脉内中膜厚度均有独立相关关系,表明高水平的血浆瘦素增加了心血管疾病风险,而高瘦素水平表现为瘦素抵抗.国内外资料就瘦素抵抗与冠状动脉微循环障碍的关系鲜有报道,现就两者间关系的研究进展做一综述.%About 50%of objects of coronary artery disease suffer from coronary microvascular dysfunction(CMD).Plenty of evidence suggests that patients with CMD have significantly higher rates of cardiovascular events,including hospitalization for heart failure,sudden cardiac death,and myocardial infarction.CMD can occur alone or in the presence with obstructive coronary artery disease.CMD shares many similar risk factors with traditional coronary artery disease,including smoking,diabetes mellitus,aging,hypertension,hyperlipidemia and obesity.Leptin can create a balance between energy intake and energy expenditure to mediate body weight in the normal physiological conditions.Interestingly,several studies have shown an independent correlation between hyperleptinemia and atherosclerosis,myocardial infarction,stroke,and coronary artery intima-media thickness,indicating that high leptin levels are associated with increased cardiovascular risk,and high leptin levels were shown to be leptin resistance.It is rarely reported at home and abroad about the relationship between leptin resistance and coronary microvascular dysfunction,and this article makes a review concerning the research progress of the relationship between them.