冠状动脉肌桥前动脉粥样硬化性狭窄的易患因素研究

Study on the susceptible factors of atherosclerotic stenosis in proximal of the coronary artery myocardial bridges

目的探讨冠状动脉肌桥前动脉粥样硬化性狭窄的易患因素。方法接受冠状动脉造影的88例心肌桥患者，其中合并肌桥前动脉粥样硬化性狭窄者67例（A组），未合并肌桥前动脉粥样硬化性狭窄者21例（B组），观察两组患者的年龄、性别、心肌桥长度、收缩压、舒张压、脉压、心肌桥压迫程度（Nobel分级）、空腹血糖、血脂等因素的差异。结果两组患者Nobel分级、收缩压、脉压比较差异均有统计学意义（P〈0．05）。而年龄、性别、心肌桥长度、舒张压、空腹血糖、总胆固醇、低密度脂蛋白胆固醇水平比较差异无统计学意义。进一步回归分析发现，Nobel分级和脉压与是否合并肌桥前动脉粥样硬化性狭窄有相关性（相关系数分别为3．0569和0．9740，P值均〈0．05）。结论高血压患者易患心肌桥，心肌桥有促发或加速肌桥前动脉发生粥样硬化的倾向，心肌桥压迫程度、脉压与是否合并肌桥前动脉粥样硬化性狭窄显著相关，而年龄、性别、收缩压、舒张压、空腹血糖、血脂、心肌桥长度与是否合并肌桥前动脉粥样硬化性狭窄无相关性。

Objective To study the susceptible factors of atherosclerotic stenosis before the coronary artery myocardial bridges. Methods The data from 88 myocardial bridge cases which received coronary angiography were statistically analyzed. Sixty-seven cases which suffered from atherosclerotic stenosis in proximal of the myocardial bridges were recruited into group A, and the other 21 eases which suffered no atheroselerotic stenosis or from atherosclerotic stenosis in distal of the myocardial bridges were recruited into group B. Difference of the age, gender, length of myocardial bridge, systolic blood pressure （SBP）, diastolic blood pressure （DBP）, pulse pressure （PP）, the oppression degree of myocardial bridge （Nobel classification）, fasting plasma glucose （FPG）, and blood fat, and so on, in two groups, were observed and statistically analyzed. Results The difference of the Nobel classification, SBP and PP in two groups showed a statistical significance （P 〈 0.05）. While the difference of the age, gender, length of myocardial bridge, DBP, FPG, total cholesterol, low-density lipoprotein in two groups showed no statistical significance （P 〉 0.05 ）. A further regression analysis suggested that Nobel classification and PP had a correlation with the complication of stenosis before the myocardial bridge （r = 3.0569,0.9740,P 〈 0.05）. Conclusions High blood pressure cases are liable to suffer from myocardial bridge. Myocardial bridges themselves trend to promote or accelerate the atherosclerotic stenosis of the coronary arteries before them. The oppression degree of myocardial bridge and PP has a correlation with the complication of stenosis before the myocardial bridge, while has no correlations with age, gender, bloodfat, SBP, DBP, FPG, length of myocardial bridge, and so on.