冠状动脉心肌桥的临床意义

Clinical significance of coronary myocardial bridge

目的:探讨冠状动脉心肌桥的临床意义。方法:回顾分析接受选择性冠状动脉造影的756例病人中检出的82例(10.8%)有心肌桥患者的资料。结果:82例心肌桥患者临床表现为稳定型心绞痛者10例(12.2%),不稳定型心绞痛者33例(40.2%),不明原因的胸痛者34例(41.5%),急性心肌梗塞者3例(3.7%),肥厚型心肌病者2例(2.4%);心肌桥近端存在冠状动脉狭窄者23例(28.0%),心肌桥远端存在冠状动脉狭窄者3例(3.7%),孤立性心肌桥(无冠脉狭窄)者46例(56.1%)。结论:心肌桥的发生率高,可导致心肌缺血,引起心绞痛;对临床疑诊心绞痛的病人应尽早常规行冠状动脉造影检查。

Objective： To discuss the clinical significance of coronary myocardial bridge. Methods： Clinical and anglographic datum of 82 patients with coronary myocardial bridge in 756 patients （10.8%） underwent selected coronary angiography were analyzed retrospectively. Results： The clinical features of the 82 patients with coronary myocardial bridge were stable angina （12.2%）, unstable angina （40.2%）, pain in thorax without knowing reasons （41.5 %）, acute myocardial infarction （3.7 % ）, hypertrophy cardiomyopath （2.4%）. In 23 （28.0 %） patients, coronary stenosis was found in the segment proximal to the myocardial bridge. In 3 （3.7 %） patients, coronary stenosis was found in the segment distal to the myocardial bridge. In 46 （56. 1 %） patients, there was no coronary stenosis was found in the coronary artery involved in the myocardial bridge. Canclusion： The occurring rate of coronary myocardial bridge is relative high. Coronary myocardial bridge may cause myocardial ischemia and angina. Early and routine coronary angiography is necessary for diagnose coronary myocardial bridge in patients with angina pectoris.