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经皮冠脉介入术可有效开通梗死相关动脉,恢复心肌灌注,但仍有部分急性心肌梗死患者,虽然已成功开通心外膜冠状动脉,仍继续表现为心肌灌注不良,即无复流.无复流可抵消经皮冠脉介入术带来的获益,是不良心血管事件和死亡的独立预测因素.无复流是一个涉及多重危险因素的复杂病理过程,主要病理生理机制包括远端栓塞、缺血损伤、再灌注损伤、个体易感性等,最终导致微血管阻塞.预防和治疗策略主要取决于其病理生理机制,单一措施、药物效果有限.“,”Percutaneous coronary intervention ( PCI ) is effective in opening the infarct related artery and restoring myocardial reperfusion in large majority of acute myocardial infarction.However there remain minority of patients ,who continue to manifest diminished myocardial reperfusion despite successful opening of the obstructed epicardial artery .This phenomenon is called no reflow ( NR).NR can attenuate the benefits of PCI therapy ,and is regarded as independent predictor of death or major adverse cardiovascular events .NR is thought to be a complex pathogenic process involving multiple risk factors.The principal pathophysiological mechanism include distal atherothrombotic embolization,ischemic injury,reperfusion injury,and susceptibility of coronary microcirculation to injury that eventually lead to microvascular obstruction.Strategies to prevent and treat NR should target these mechanisms.There is no single effective drug or measure for treatment duo to the complex pathogenesis.