心肌桥的冠脉造影与临床研究

The coronary angiography and clinical study of myocardial bridge

目的探讨心肌桥检出率、临床特征、诊断和治疗、预后等。方法采用SPSS统计学软件进行统计分析,计数资料采用卡方分析,回顾性分析580例冠脉造影检出52例心肌桥患者的临床特征。结果冠脉造影心肌桥检出率10.69%,肥厚型心肌病占10%,糖尿病占20.96%,高血压占29.03%,既无高血压又无糖尿病占50%,多数心肌桥发生在左冠状动脉,少数发生在右冠状动脉,心肌桥长度8-31 mm。孤立性肌桥43例(69.3%)。结论(1)心肌桥可以引起不同程度的心肌缺血症状,但应用硝酸酯制剂可以加重心肌桥反应;(2)心肌桥可继发动脉粥样硬化的形成,严重者可诱发急性冠脉综合征的发生;(3)先天发育、左心室肥厚、高血压和肥厚型心肌病与心肌桥的临床发生存在相关性;(4)心肌桥的发生与血糖、血脂、CRP、血沉、尿酸等无明显相关性;(5)有症状的心肌桥首选药物治疗,无效时考虑手术治疗,支架治疗远期效果差。

Objective to investigate the incidece of myocardial bridge through coronary angiography, the clinical features of myocardial bridge , its clinical presentation, treatment, evaluation of efficacy, and prognosis. Methods Uses SPSS statistics software to make the statistical analysis, and counts date using chi-square analysis. Results the incidence of myocardial bridge through coronary angiography was 10.69% ,Hypertrophic cardiomyopathy accounted for 10% ,the diabetes accounted for 20.96%, hypertension accounted for 29.03%, Both non-hypertension and non-diabetes accounted for 50%, myocardial bridge which accounted in the left coronary artery accounted for major cases, in the right coronary arteryaccounted for small cases, There are 9 cases with atherosdernsis stenosis at the same coronary artery. 53 cases with atheroselerosis stenosis at the other coronary artery. The length of myocardial bridge was 8 - 31 mm. Isolated myocardial bridge 43 cases（69.3% ）. Conclusion： （ 1 ） Myocardial bridge may cause myocardial ischemia symptoms, and nitrates agents may increase the reaction of myocardial bridge; （2）Myocardial bridge can continue to cause the formation of atherosclernsis, serious may even induse severe acute myocardial infarction; （3）Congenital development, left ventricular hypertrophy, hypertention and hypertrophic cardiomyopthy all had clinical correlation with myocardial bridge; （4）There are no significant correlation between blood glucose, blood fat, CRP, ESR, uric acid and myocardial bridge; （5）The first treatment for sympatomatic myocardial bridge is medication and surgery should be considered when medication has a poor result as we known, The stent therapy leads to poor result for long time.