microcirculationРегионарное кровообращение и микроциркуляцияRegional blood circulation and microcirculation1682-66552712-9756Academician I.P. Pavlov First St. Petersburg State Medical University10.24884/1682-6655-2021-20-3-4-10microcirculation-968Research ArticleОБЗОРЫREVIEWSПредикторы реперфузионного синдрома миокарда: современный взгляд на вопрос и актуальные проблемы. Часть 2: феномен невосстановленного коронарного кровотока, или феномен no-reflow (обзор литературы)Predictors of myocardial reperfusion syndrome: a modern view of the issue and current problems. Part 2: no-reflow phenomenon (literature review)ХубулаваГ. Г.KhubulavaG. G.

Хубулава Геннадий Григорьевич – д-р мед. наук, профессор, академик РАН, зав. кафедрой и клиникой хирургии (усовершенствования врачей) №1

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Khubulava Gennady G. – MD, Professor, Academician the Russian Academy of Sciences, Head of the Departmentand Clinic of Surgery (Improvements of Doctors) № 1

6, Academiva Lebedeva street, Saint Petersburg, Russia, 194044

as015@rambler.ruКозловК. Л.KozlovK. L.

Козлов Кирилл Ленарович – д-р мед. наук, профессор, профессор кафедры хирургии (усовершенствования врачей) №1

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

 

Kozlov Kirill L. – MD, professor, professor of the Department and Clinic of Surgery (Improvements of Doctors) № 1

6, Academiva Lebedeva street, Saint Petersburg, Russia, 194044

kozlov_kl@mail.ruШишкевичА. Н.ShishkevichA. N.

Шишкевич Андрей Николаевич – д-р мед. наук, начальник рентгенохирургического отделения клиники хирургии (усовершенствования врачей) № 1

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Shishkevich Andrey N. – MD, head of the X-ray surgical department of the Surgery Clinic (Improvements of Doctors) № 1

6, Academiva Lebedeva street, Saint Petersburg, Russia, 194044

shishkevich50@mail.ruМихайловС. С.MikhaylovS. S.

Михайлов Сергей Сергеевич – канд. мед. наук, старший ординатор рентгенохирургического отделения клиники хирургии (усовершенствования врачей) № 1

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Mikhaylov Sergey S. – Ph. D., senior resident of the X-ray surgery department of Surgery Clinic (Improvements of Doctors) № 1

6, Academiva Lebedeva street, Saint Petersburg, Russia, 194044

mikhailov.vma@gmail.comБессоновЕ. Ю.BessonovE. Yu.

Бессонов Евгений Юрьевич – ординатор рентгенохирургического отделения клиники хирургии (усовершенствования врачей) № 1

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

 

Bessonov Evgeny Yu. – resident of the X-ray surgical department of the Surgery Clinic (Improvements of Doctors) № 1

6, Academiva Lebedeva street, Saint Petersburg, Russia, 194044

ewgenijbessonov@yandex.ruТокаревП. А.TokarevP. A.

Токарев Павел Александрович – врач-РХМДЛ клиники хирургии (усовершенствования врачей) № 1

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Tokarev Pavel A. – X-ray surgeon of the Surgery Clinic (Improvements of Doctors) № 1

6, Academiva Lebedeva street, Saint Petersburg, Russia, 194044

ПачковД. А.PachkovD. A.

Пачков Дмитрий Алексеевич – врач – анестезиолог-реаниматолог клиники хирургии (усовершенствования врачей) № 1

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Pachkov Dmitry A. – anesthesiologist-resuscitator of the Surgery Clinic (Improvements of Doctors) № 1

6, Academiva Lebedeva street, Saint Petersburg, Russia, 194044

pachkov.dmitriy@gmail.ruБобровскаяЕ. Е.BobrovskayaE. E.

Бобровская Екатерина Евгеньевна – канд. мед. наук, преподаватель кафедры хирургии (усовершенствования врачей) № 1

194044, Санкт-Петербург, ул. Академика Лебедева, д. 6

Bobrovskaya Ekaterina E. – Ph. D., lecturer of the department of the Surgery Clinic (Improvements of Doctors) № 1

6, Academiva Lebedeva street, Saint Petersburg, Russia, 194044

Федеральное государственное бюджетное военное образовательное учреждение высшего образования «Военно- медицинская академия имени С. М. Кирова» Министерства обороны Российской ФедерацииРоссияMilitary Medical AcademyRussian Federation202126092021203410Copyright © Хубулава Г.Г., Козлов К.Л., Шишкевич А.Н., Михайлов С.С., Бессонов Е.Ю., Токарев П.А., Пачков Д.А., Бобровская Е.Е., 20212021Хубулава Г.Г., Козлов К.Л., Шишкевич А.Н., Михайлов С.С., Бессонов Е.Ю., Токарев П.А., Пачков Д.А., Бобровская Е.Е.Khubulava G.G., Kozlov K.L., Shishkevich A.N., Mikhaylov S.S., Bessonov E.Y., Tokarev P.A., Pachkov D.A., Bobrovskaya E.E.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.microcirc.ru/jour/article/view/968

Несмотря на то, что феномен невосстановленного коронарного кровотока (no-reflow) давно известен, до сих пор нет однозначного мнения на счет предикторов, а соответственно, и групп риска его возникновения. Это препятствует прогнозированию дальнейшего течения заболевания и исследованию эффективности терапевтических и хирургических способов предотвращения последствий реперфузии у пациентов с инфарктом миокарда с подъемом сегмента ST, что, в свою очередь, ухудшает послеоперационный и отдаленный прогноз у данной группы больных. Для поиска исследований по этой проблеме мы использовали поисковые системы E-lilbrary, Google Scholar и Pubmed. В статье представлены данные исследований, освещающих предикторы феномена no-reflow, проведен их анализ. Также описаны сложности их выявления, поднята проблема диагностического подхода и формирования выборки для исследований. Дан обзор исследований, посвященных выявлению предикторов феномена no-reflow с помощью оптической когерентной томографии и внутрисосудистого ультразвукового исследования.

Despite the fact that the phenomenon of unrecovered coronary blood flow (no-reflow) has long been known, there is still no unanimous opinion about the predictors and, accordingly, the risk groups for its occurrence. This prevents predicting the further course of the disease and investigating the effectiveness of therapeutic and surgical methods for preventing the consequences of reperfusion in patients with ST-segment elevation myocardial infarction, which in turn worsens the postoperative and long-term prognosis in this group of patients. We used the search engines E-library, Google Scholar and Pubmed to search for studies on this issue. The article presents and analyzes research data covering the predictors of the no-reflow phenomenon. The difficulties in identifying them are also described, the issue of a diagnostic approach ans sampling for research is raised. A review of studies dedicated to the identification of predictors of the no-reflow phenomenon using optical coherence tomography and intravascular ultrasound is given.

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The authors declare that there are no conflicts of interest present.