心肌桥的解剖学特征和粥样硬化的关系探讨

Discussion on relationship between the anatomic characteristics of the myocardial bridge and atherosclerosis

目的探讨冠状动脉心肌桥的解剖学特征和冠状动脉粥样硬化的关系。方法选取十堰市红十字医院200例经解剖证实的冠状动脉左前降支被心肌桥包裹且并无其它任何原发性心血管疾病的患者的尸体解剖心脏标本为观察组,另选100例无冠状动脉心肌桥的正常人为对照组;观察组按冠状动脉心肌桥距左冠状动脉起始处距离分为近端动脉(冠状动脉心肌桥距左冠状动脉起始处<3.5 mm,n=62)、中端动脉(冠状动脉心肌桥距左冠状动脉起始处3.5～5.0 mm,n=58)、远端动脉(冠状动脉心肌桥距左冠状动脉起始处>5.0 mm,n=80)。分析冠状动脉心肌桥不同位置及年龄对粥样硬化指数的影响。结果①观察组中,120例(60%)有1条冠状动脉心肌桥,62例(31%)有2条冠状动脉心肌桥,18例(9%)有3条或者3条以上的冠状动脉心肌桥。冠状动脉心肌桥距离左冠状动脉起始位置的平均距离为(4.38±1.08)cm。冠状动脉心肌桥近端动脉、中端动脉、远端动脉的粥样硬化指数分别为(1.83±0.89)、(0.76±0.31)、(0.88±0.44);其中,冠状动脉心肌桥近端动脉的粥样硬化指数高于中端动脉及远端动脉,差异均有统计学意义(P<0.05)。②54～<60岁的近端动脉、中端动脉、远端动脉粥样硬化指数低于60～<70岁者,60～<70岁的近端动脉、中端动脉、远端动脉粥样硬化指数低于70～<80岁者,70～<80岁的近端动脉、中端动脉、远端动脉粥样硬化指数80～85岁者,差异均有统计学意义(P<0.05)。结论冠状动脉心肌桥的解剖学特征与冠状动脉粥样硬化的发生密切相关。

Objective To research relationship between the anatomic characteristics of the myocardial bridge and atherosclerosis.Methods 200 cases in the Red Cross Hospital of Shiyan City confirmed by the anatomical left anterior descending coronary myocardial bridge wrapped and did not have any other primary cardiovascular disease in patients with autopsy heart specimens were observed as observation group;100 normal subjects with no coronary myocardial bridge were selected as the control group.The observation group was divided into the proximal artery（distance from coronary myocardial bridge to the start of left coronary artery3.5 mm,n=62）,middleend artery（distance from coronary myocardial bridge to the start of left coronary artery 3.5-5.0 mm,n=58）,the distal artery（distance from coronary myocardial bridge to the start of left coronary artery5.0 mm,n=80）.Influence of different location of coronary artery myocardial bridge and age to atherosclerosis index were analyzed.Results ①120 cases（60%） with 1 coronary artery myocardial bridge were found in observation group,62 cases（31%） with 2 coronary artery myocardial bridges were found in observation group,18 cases（9%） with 3 or more coronary artery myocardial bridges were found in ob servation group.The average distance from coronary myocardial bridgeto the start of left coronary artery were（4.38 ± 1.08） cm.atherosclerosis index of proximal artery,middleend artery,distal artery were（1.83 ±0.89）,（0.76 ±0.31）,（0.88±0.44） respectively;atherosclerosis index of proximal artery were higher than those of middleend artery and dis tal artery,the differences were statistically significant（P 〈0.05）.②Atherosclerosis index of 54-60 years old were lower than those of 60-〈70 years old,atherosclerosis index of 60-〈70 years old were lower than those of 70-〈80 years old,atherosclerosis index of 70-〈80 years old were lower than those of 80-〈85 years old,the differences were statistically significant（P〈 0.05）.Conclusion Anatomical features of the myocardial bridge is closely related to the occurrence of coronary atherosclerosis.