冠状动脉左前降支心肌桥与冠心病关系的初步探讨

The preliminary study on the relationship between left anterior descending coronary myocardial bridging and coronary heart disease

目的探讨冠状动脉左前降支心肌桥与冠心病之间的关系。方法经冠状动脉造影证实左前降支(LAD)心肌桥患者100例,收集患者各项基础特征资料,以收缩期受压缩程度间隔10%为单位,比较冠心病与非冠心病组间各指标差异,寻找冠心病的独立预测因子。结果 100例LAD心肌桥患者,其中中段79例、远段19例,90.3%以上动脉粥样硬化发生在心肌桥之前节段。冠心病组57例,非冠心病组43例,在心肌桥收缩期压缩至少≥70%时,2组患者比较差异有统计学意义。Logistic回归显示,男性、重度心肌桥、血糖异常为冠心病的独立预测因子,总体预测概率ROC曲线下面积为0.798,诊断准确度达到中等水平。结论心肌桥多发生在LAD中段及远段,以中段居多,冠状动脉粥样硬化多发生在心肌桥之前节段;男性、重度心肌桥、血糖异常可作为冠心病的独立预测因子,具有重要的临床参考价值。

Objective To study the relationship between left anterior descending coronary（ LAD） myocardial bridging and coronary heart disease. Methods 100 patients with LAD myocardial bridging were confirmed by coronary angiography（ CAG）,collected the basic characteristics of the patients,with the systolic compression degree interval 10% for one unit,and the differences were compared between the index of coronary heart disease group and non- coronary heart disease group,then found the independent predictive factors for coronary heart disease. Results In the 100 patients with LAD myocardial bridging,79 myocardial bridges on the middle segment of LAD,and another 19 myocardial bridges on the distal segment of LAD,more than 90. 3% of atherosclerosis occurred in the segment before the myocardial bridging. 57 people in the coronary heart disease group and 43 people in the non- coronary heart disease group,compared the indexes between the two groups,there were significant differences between the two groups when myocardial bridging in systolic were compressed more than or equal 70%. The logistic regression analysis showed that the indexes of the men,severe myocardial bridging and abnormal glucose were the independent predictive factors for coronary heart disease. The area under the ROC curve was 0. 798 and the diagnostic accuracy can reach medium level. Conclusion Most myocardial bridges are found on the middle or the distal segments of LAD,and the number in the middle segments are more than the distal segments,and coronary artery atherosclerosis often occurs in the segments before the myocardial bridge segments. The indexes of the men,severe myocardial bridge and abnormal glucose can be used as the independent predictive factors for the coronary heart disease,which has important clinical reference value.