冠状动脉心肌桥63例临床分析

Clinical analysis of coronary myocardial bridge in 63 cases

目的探讨选择性冠状动脉造影中心肌桥的检出率及其临床意义。方法回顾分析接受冠状动脉造影的1825例患者资料,其中检出心肌桥63例,检查方法采用选择性冠状动脉造影术。左冠状动脉至少采用4个以上投照角度,右冠状动脉至少采用2个以上相互垂直的投照角度进行造影以充分暴露冠状动脉各节段。结果 1825例行冠状动脉造影患者中,检出心肌桥63例,心肌桥检出率为3.45%,心肌桥均分布在前降支,Nobel分级:Ⅰ级33例(占52.4%),Ⅱ级25例(占39.7%),Ⅲ级5例(占7.9%)。结论选择性冠状动脉造影可用于活体患者心肌桥的诊断,心肌桥可能引起心肌缺血表现引起心绞痛,对可疑心绞痛的患者应尽早行常规冠状动脉造影检查。应用β受体阻滞剂、钙离子拮抗剂、介入治疗或外科治疗有效。

Objective To study the incidence and clinical features of coronary myocardial bridge （CMB） in patients under coronary angiography（CAG）. Methods The data of 1 825 patients receiving coronary arteriongraphy was analyzed, and 63 patients were found with myocardium bridge, the selective coronary angiography was used, the angle of radiophy were four in the left coronary artery and two angle in the right coronary artery. Results 63 patients with myocardium bridge in 1 825 patients receiving coronary arteriongraphy were found, positive rate of myocardium bridge was 3.45%, all the patients with myocardial bridge were observed in the left anterior descending coronary, according to the Nobel＇s grade, 33 cases （52.4%）of gradeⅠ, 25 cases （39.7%）of gradeⅡ and 5 cases（7.9%） of gradeⅢ. Conclusion Selective coronary angiography could be used to diagnose coronary myocardial bridge. Coronary myocardial bridge might cause myocardial ischemia and angina. Early and routin coronary angiography is necessary for diagnose coronary myocardial bridge in patients with angina pectors. Medicine such as β-blocker, calciumium antagon, intervational or surgery are all effective.