冠状动脉心肌桥的临床诊疗与分析

The Clinical Diagnosis and Analysis of Coronary Muscle Bridge

目的:探讨冠状动脉心肌桥的临床诊断及治疗。方法:对2012年1月-2013年12月本院接受冠脉造影的1506例患者进行回顾性分析,均采用右侧桡动脉穿刺途径行选择性冠脉造影。结果:共检出心肌桥54例,检出率为3.6%,均位于前降支。46例患者有不同程度的胸闷、胸痛,5例以心悸为首发症状就诊,2例因查体发现心电图异常就诊,25例心电图有静息状态下ST-T改变。53例患者选择药物治疗,仅1例行外科肌桥松解术,所有患者随访症状均明显缓解。结论:冠状动脉肌桥多发于前降支,可导致胸闷、心悸等临床症状,治疗上可用β受体阻滞剂和/或非二氢吡啶类钙离子拮抗剂,严重者可选用支架植入术或外科肌桥松解术。

Objective：To evaluate the clinical diagnosis and treatment of coronary myocardial bridge. Method：1506 patients who accepted coronary arteriography from January 2012 to December 2013 in our hospital were retrospectively analyzed. They all adopted the right radial artery puncture route line of selective coronary angiography. Result：54 patients with myocardial bridge were identified,The detected ratio was 3.6%. All these patients were over the left anterior descending LAD.46 patients with varying degrees chest pain,5 patients with palpitations as the first symptom,2 patients were found abnormal ECG,25 patients’ECG have resting ST-T changed. 53 patients was treated with drug,only one case chose myotomy on myocardial bridge. All patients were followed up for symptoms relieved. Conclusion：Myocardial bridges are found most often at the left anterior descending coronary artery and can cause chest tightness,heart palpitations and other symptoms.β-blockers and（or）non-dihydropyridine can be used in medical treatment,Serious cases can chose the surgery treatment such as myotomy on myocardial bridge and CABG.