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冠状动脉心肌桥18例临床分析 被引量:4

Clinical analysis of coronary myocardial bridge in 18 cases
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摘要 目的探讨行选择性冠状动脉造影人群中冠状动脉肌桥的发生率、临床特点及预后。方法回顾性总结我院1991年12月至2002年5月接受选择性冠脉造影2876例的临床资料。结果在2876例行选择性冠脉造影的人群中,共发现18例冠状动脉肌桥,发生率为0.626%,均为左前降支心肌桥。收缩期狭窄≥50%的有15例,其中8例收缩期狭窄≥75%。14例有心绞痛症状。8例收缩期狭窄≥75%的患者行心肌核素显像提示前壁心肌缺血。2例患者发生前壁心肌梗塞,其心肌桥于收缩期致100%血流阻断。使用b-阻滞剂可缓解心肌桥所致心绞痛。16例随访1~5年,无1例新发心肌梗塞、心脏性猝死及左心功能不全。结论冠状动脉肌桥多发生于左前降支,可致心肌缺血或心肌梗塞。b-阻滞剂可缓解所致心绞痛,极少心肌桥患者需行心肌桥剥离术。冠状动脉内支架术可能是治疗冠状动脉心肌桥安全有效的办法。冠状动脉心肌桥患者预后较冠状动脉固定狭窄的冠心病患者为好。 ObjectiveTo study the incidence, clinical features and prognosis of coronary myocardial bridge (CMB) inpatients under coronary angiography (CAG).MethodsClinical data of 2876 patients under CAG in our hospital from 1991to 2002 were analyzed retrospectively.ResultsIn 2876 cases, 18 patients had CMB. The total incidence of CMB was0.626%, all these CMB were over the left anterior descending arteries (LAD). 15 patients had systolic narrowing coronaryartery with stenosis ≥50%. In these 15 cases, 8 patients had severe systolic narrowing coronary artery (stenosis≥75%). Allthese patients had angina pectoris and myocardial ischemia. 2 patients were diagnosed to be anterior myocardial infarctionwith LAD systolic total occlusion. Beta receptor blocker could be effective to the patients with CMB.ConclusionsCMBis responsible for myocardial ischemia and myocardial infarction.
出处 《罕少疾病杂志》 2003年第4期9-10,共2页 Journal of Rare and Uncommon Diseases
关键词 冠状动脉造影 心肌桥 心绞痛 心肌梗塞 临床资料 myocardial bridge coronary angiography angina pectoris
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