单纯左前降支心肌桥对心肌供血影响的观察

Analyzing the impact of myocardial blood supply in left anterior descending coronary artery myocardial bridge

目的分析单纯冠状动脉左前降支心肌桥病变对心肌供血的影响。方法 90例研究对象按冠状动脉造影特征分为3组:单纯冠状动脉左前降支心肌桥组(A组),单纯冠状动脉左前降支狭窄组(B组)及正常冠状动脉组(C组)各30例。比较3组之间的一般资料、心肌缺血表现;并采用校正的TIMI帧数(CTFC)对冠脉血流速度进行评估。结果 A组患者平均年龄低于B组(P<0.05),性别、平均血压、心率差异无统计学意义(P>0.05)。A组心肌梗死发生率、ST-T异常率低于B组(P<0.05),心绞痛表现差异无统计学意义(P>0.05)。A组CTFC较C组明显增高(P<0.05),血流速度缓慢,血流到达血管远端时间延长(P<0.05)。结论单纯冠状动脉左前降支心肌桥主要发生于年轻男性中,冠脉血流缓慢,可引起心肌缺血。

Objective To analyze the impact of myocardial blood supply in patients with left anterior descending coronary artery（LAD）myocardial bridge.Methods Ninety patients were divided into three groups according to the coronary angiography： simple coronary artery myocardial bridge（group A,n=30）,simple coronary artery stenosis（group B,n=30）and normal coronary artery（group C,n=30）.The general materials,myocardial ischemia were observed and compared,and the coronary artery blood flow velocity and blood flow were evaluated by corrected TIMI frame count（CTFC）method.Results The average age in group A was lower than group B（P0.05）,with no statistical difference in gender,mean blood pressure, heart rate,etc（P0.05）.The ratio of myocardial infarction and abnormal ECG changes was lower than group B（P0.05）,while no statistical difference in angina（P0.05）.The CTFC in group A was significantly higher than that in group C（P0.05）,coronary blood flow velocity was decreased and it took more time to reach the distal of the vessel（P0.05）. Conclusion The simple coronary artery myocardial bridge was prefer to involve young male,with coronary blood flow velocity decreased and caused myocardial ischemia.