冠脉照影心肌桥患者的临床特点 - 第三军医大学学报.docVIP

77例冠脉影心肌桥患者的临床特点和治疗分析 何文一，张冬颖△ (重庆医科大学附属第一医院心血管内科， 400016) 摘要: 目的 观察分析冠状动脉心肌桥患者的临床特征，探讨其治疗方法。方法 对比分析经冠状动脉影确诊心肌桥患者7例，与阴性患者88例的临床症状、基本特征、生化指标、心电图、心脏彩超造影情况。结果 63例行冠脉造影患者共检出心肌桥7例，男性4例(64.3％)，除1例位于回旋支其余均位于前降支(98％)。相比，。结论 心肌桥可能导致心肌缺血，引起心绞痛，冠脉造影是心肌桥诊断的金标准，治疗以β受体阻滞剂、钙离子拮抗剂必要时可考虑行冠状动脉支架安置术或行外科手术。关键词 冠状动脉造影；心肌桥；临床特点Clinical features of coronary angiography diagnosed patients with myocardial bridge HE Wen-yi, ZHANG Dong-ying (Department of cardiology，The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, China) Abstract: Objective To analyze the clinical features and explore the treatment in patients with coronary artery myocardial bridge. Methods Comparative analysis of clinical symptoms, basic features, biochemical parameters, electrocardiogram, cardiac color doppler ultrasound and treatment followed-up after 6-12 months among 77 cases of patients with myocardial bridge，107 patients with CAD and 88 negative cases. Results 77 cases with myocardial bridge were detected in 693 routine coronary angiography, 49 male (64.3％)located in the left former descending branch except 1 case located in LCX. 65 of them were single bridge. There is significant differences among three groups.ECG and clinical symptoms in patients with myocardial bridge are similar with CAD patients,and there are significant differences between these patients and negative cases.Medical treatment is the main way, the total effective rate 85%.Conclusion Myocardial bridge may cause myocardial ischemia, angina, coronary angiography is the gold standard in the diagnosis, treatment with β-blockers and calcium antagonists is the main way, when necessary, coronary stent placement or surgical treatment should be considerated. .Key word: myocardial bridge; Coronary angiography; Clinical features；treatment effect 心肌桥是一种常见先天性解剖异常，当冠状动脉或其分支的某个节段走行于室壁心肌纤维之间，被形似桥的心肌纤维覆盖，在心脏收缩时出暂时性管腔狭窄甚至闭塞，被心肌纤维覆盖的动脉段称为壁冠状动脉，这段心肌纤维称为冠状动脉心肌桥(简称心肌桥，myocardial bridging，MB)。近年发现心肌桥对冠状动脉的收缩期压迫不仅导致收缩期心肌血流灌注减少，而且舒张早、中期心肌灌