??????????? ?????? ?????? - ????????????? – ?????? ??????? ???????? ??????? ??????????? ????????. ?????? ???????????? CASPAR.

????????????? – ?????? ??????? ???????? ??????? ??????????? ????????. ?????? ???????????? CASPAR.

? ?????? ??????? ? ?????? ?????????? ????????? (???) ??? ?????????? ??????????????????? (???) ?? ?????????? ??????????????? ???????? ????????? ?????????? ???????, ??????? ????? ???? ?? ???????? ?????????????? ?? ??????????????? ??????????? ???????. ? ???? ????? ???????? ?????? ??????? ????????????? ???????????? CASPAR (Coronary Artery Spasm in Patients With Acute Coronary Syndrome), ????? ???????? ???? ????????? ??????? ?????????????? ?????? ?????????? ??????? (???) ? ??????? ??? ??? ??????? ??????????????? ????????? ?? ???.
?????? ? ??? ????????????.
? ???? ?? ??????? 2006 ?. ? ???????????? ?????????? ??????????????? ??????????????????? ???????? ? ???, ???????????? ??? ?????????? ???? ? ????? ?????????????????? ????? 20 ????? ?? ????????? 48 ????? ? ???????????? ??????????? ??????????????????? (???) ?/??? ?????????? ???????? ??????? ????????. ???? ?????????? ??????????? ???, ? ??? ??????? ???????? ???????? ?????????? ??????? – ???????????????? ????????. ???? «?????????????» ????????? (culprit lesion) ?? ??? ?? ??????????, ?? ????? ????? ?? ???????????? (??? ?????????? ? ??????????? ?? ????????? ????????) ?????????????? ???????? ??????????? (??) ? ???????????????? ????? 2, 20 ? 100 ??? ?????? 3 ?????? ? ????? ?????????? ???????, ????? (??? ????????????? ??????????) – 80 ??? ? ?????? ?????????? ???????. ? ?????? ?????????? ??? ??? ??? ??????????? ?????????????? 0,2 ?? ?????????????? (???????????; Schwarz Pharma, ????????).
??? ????? ? ?? ???? ??????? ? ??????? ?????????????? ??? (????????? QCA-CMS 7.0; Medis-Software, Leiden; ??????????). ???? ??????????? ????????????? ??? ??????????????? ≥75% ?? ????????????? ???????? ?????????? ???????, ??????????? ????? ???????? ??????????????, ?????? ? ???????????????? ?????????????? ??????????? ?????????.
??????????.
?? 488 ?????????? ? 350 ???? ???????? ??????????????? ???????? ????????? ??????????? ?????, ? 138 ??????? – ???. ???????? ?? ????????? ????????? ???? ?????? (67 ?????? 62 ???; ?<0,0001), ???? ???????? ???? (71% ?????? 48%; ?<0,0001) ? ? ???????? ???????? (33% ?????? 19%; ?=0,002), ????? ????? ??????? ?????? ???????? ??????? ???????? (?<0,001) ? ?????????????? ???? ????????? ? ????????? ????????, ??? ??????? ??? ???????? ????????? ?????????? ??????? (?<0,001).
????? 138 ??? ??? ?????????? ???????? ? 18 ????????? ??? ?????????? ???????, ???????? ?? ???: ? 9 – ?????????, ? 7 – ?????????????? ???????? (tako-tsubo), ? 1 – ?????? ????????????, ? 1 – ???????? ???????. ? 4 ??????? ??? ??? ??????? ??? ????? ? ????????????? (??) ?? ????????? ??????????????.
?? ?????????? 116 ?????????? ????? ? ??????????????? ????????? ?? ???? ????????? ? 86 ?????????. ??? ? ???????????????? ??????????? ????????? (?????????? ????) ??? ????????????? ? 42 ??????? (49% ?? ????????????? ??? 30% ?? ???? ??????? ??? ???????? ?????????? ????????). ????????? ??? ?? ????? ???????? ?? ??? ????? ????? ???? ???????? ? 20 ????????? (48%): ? 17 ??????? – ????????? ???????? ST, ? 3 – ??? ??????. ? 6 ??????? ??? ?????????? ??? ??? ??? ???????????????? ?????? 6 ????????? ???, ?? ??????? ????????? ???????? ?? ????; ??? ? 6 ??????? ??? ?? ????? ???? ???????????????? ??-?? ???????? ????????? ????????????? ?????????; ? ????????? – ?????? ?????? ?? ??? ????? ???? ?????????? ??-?? ??????????? ??????? ??? ??????????? ?????? 6 ?????????.
??????.
???????? ?????? ???????????? CASPAR , ?????? ????????? ???????, ??????????? ? ???, ?? ????? ??????????????? ???????? ????????? ?????????? ??????? ??? ???. ????? ???? ??????? ???, ????????????????? ??? ??????????????? ???????? ??, ?????????? ? ???????? ???????. ?????? ?? ?????, ????????? ?????????????, ????? ?????????????? ??????? ???????? ?????? ???????? ???????? ???. ??? ?????, ???? ?? ??????? ??? ?????? ??????????? ??? ?????????? ????????????????? ???????? ?? ?????????? ??????. ??????????????? ???????? ?? ???????? ???????? ? ?????????? ??????? ?????????? ????????? ???, ??? ? ?????? ?????????????? ?????????? ????????? ????????? ????? ?????????? ??????? ???????????.
????????.
Ong P., Athanasiadis A., Hill S. et al. Coronary Artery Spasm as a Frequent Cause of Acute Coronary Syndrome. The CASPAR (Coronary Artery Spasm in Patients With Acute Coronary Syndrome) Study. J Am Coll Cardiol. August 12, 2008;52:523–7. ??????-???????? Medline ????????

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