冠状动脉心肌桥分布特征及治疗效果分析

Clinical character and the treatment of myocardial bridge

目的 :分析冠状动脉心肌桥的分布特征及治疗效果。方法 :分析接受选择性冠状动脉造影的 30 5 1例患者中检出的心肌桥 12 1例。结果 :8例心肌桥患者接受内科介入治疗 ,1例行外科心肌桥松解术 ,74例孤立性心肌桥患者接受内科药物治疗。药物治疗以β受体阻滞剂、钙离子拮抗剂改善症状明显 ,总有效率 82 % (6 1/ 74 )。心肌桥 96 %发生于左冠状动脉前降支。本组孤立性心肌桥 83例随访 1月～ 5年 ,1例发生急性心肌梗死 ,无猝死发生。结论 :心肌桥可能导致心肌缺血 ,引起心绞痛 ,治疗以β受体阻滞剂、钙离子拮抗剂首选。必要时可考虑行冠状动脉支架植入术或行外科松解手术。

AIM:To investigate the clinical character and treatment of coronary myocardial bridge. METHODS: 121 patients with myocardial bridge in 3051 patients who underwent selective coronary angiography were retrospectively analyzed.RESULTS: Among these patients, there are 1 patient underwent operation,8 patients underwent coronary stenting and medicine treatment was performed in 74 patients with isolated myocardial bridges. After have treated by β-blocking agents and calcium channel blocker,symptoms of angina pectoris were relieved obviously. 96% myocardial bridges were in left anterior decending branches. There are 83 patents with isolated myocardial bridges were followed for 1 month to 6 years. Acute myocardial infarction occured in 1 patient and no sudden death, acute heart failure accured in these patients. CONCLUSION: Coronary myocardial bridge may cause myocardial ischemia and angina, and thrapy of β-blocking agent and calcium channel blocker are effective treatment. If medicine treatment hasn’t any effect,they should undergo coronary stenting or operation overlying myocardium.