冠状动脉肌桥的造影特点及临床治疗分析

Angiographic Features and Clinical Treatment of Coronary Myocardial Bridge

目的探讨冠状动脉造影人群中冠状动脉桥的造影特点及临床治疗方法。方法回顾性分析接受选择性冠状动脉造影1058例患者的临床资料。结果在1058例行选择性冠状动脉造影人群中,发现冠状动脉心肌桥67例(6.3%),64例发生于左前降支(LAD),仅2例见于左回旋支(LCX),1例见于右冠;收缩期狭窄>50%的有35例,收缩期狭窄>75%有17例;14例有典型心绞痛症状,51例症状不典型,2例为心肌梗死患者,所有患者均应用β受体阻滞剂及钙通道阻滞剂治疗,其中孤立性心肌桥患者中有20例患者症状明显改善;合并单支病变36例患者以及合并双支病变的10例患者对狭窄的靶血管行PCI术后给予β受体阻滞剂及钙通道阻滞剂治疗,患者症状明显改善。结论心肌桥常见于LAD,常引起典型的心绞痛,钙离子拮抗剂及β受体阻滞剂可缓解症状。极少数病例需行PCI及外科手术治疗。

Objective To discuss the angiographic features and clinical treatment of coronary myocardial bridge （ CMB ）. Methods A retrospective analysis was made to the clinical data of 1058 cases receiving selected coronary arteriongraph （ CAG）. Results Out of the 1058 cases, CMB was found in 67 cases （6.3% ）, among which, 64 cases in the left anterior deseending （LAD）, 2 cases in LCX and lease in the fight aetefia eomnaria; 35 cases had coronary stystolic stenosis greater than or equal to 50% while 17 cases greater than or equal to 70% ; 14 cases showed out typical symptoms of angina pectoris and 51 cases showed out atypical ones, 2 eases had myocardial infarction; all patients received the treatment of β receptor block agent and calcium antagon block agent, 20 eases with isolated myocardial bridge showed obvious symptom improvement as weU as 36 cases with single branch lesion and 10 eases with double branch lesion receiving percutaneons coronary intervention （PCI） before the treatment, Conclusion Myocardial Bridge is often found in LAD, which causes typical symptom of angina pactoris; Calcium antagon and β receptor block agent are effective in relieving the symptom of CMB; Few cases need PCI or surgery.