冠状动脉心肌桥与心肌缺血关系的研究

Myocardial Bridges and Myocardial Ischemia

目的：探讨心肌桥（MB）与心肌缺血的关系。方法：回顾分析冠脉造影中检出的88例MB患者，把其中36例孤立性MB分为两组（A组：NobleI级；B组：NobleⅡ～Ⅲ级），卡方检验分析：（1）壁冠状动脉及其前后冠脉的粥样硬化发生率差异；（2）A、B组的动态心电图的ST—T段改变发生率、运动平板阳性率、稳定性心绞痛发生率、不稳定性心绞痛发生率的差异。结果：MB检出率4．1％，B组与A组相比，运动平板阳性率、稳定性心绞痛发生率、不稳定性心绞痛发生率明显升高（P〈0．05）；MB近段冠脉的AS发生率高于壁冠状动脉及MB远段冠脉（P〈0．01）。结论：MB的狭窄程度越严重，引起的心肌缺血越重；MB促进近段冠脉粥样硬化的发生。

Objective：To investigate the relationship between myocardial bridges（MB） and myocardial ischemia. Methods：The present study contained 84 patients with MB（including 36 patients with isolated MB）found on coronary angiographies（CAG）. 36 patients with isolated MB were subdivided into group A （degree of the Noble） and group B （degree Ⅱto Ⅲ of the Noble）. Chisquare criterion was employed to analyze the distinction of incidence rate of atherosclerotic lesion in proximal and within,distal segments of MB,and was used to analyze the difference of the positive rate of treadmill ,holter,stable angina pectoris（SAP）and unstable angina pectoris（UAP） between group A and group g. Results ：MB was detected in 84 out of 2083 patients,with an isolating rate of 4.1%. The positive rate of treadmill, holter,SAP and UAP in group B was higher than that in group A（P〈0.05）,the incidence rate of atherosclerotic proximal to the bridge was higher than that in within or distal segments. Conclusions：The more serious degree of MB,the more severe myocardial and the higher itacidence rate of angina pectoris ischemia causes by MB;MB may initiate the development of atherosclerotic lesion in the proximal segment of MB.