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|本期目录/Table of Contents|

冠状动脉心肌桥342例临床特点及预后分析

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2014年第2期
页码:
196-199
栏目:
临床研究
出版日期:
2014-01-20

文章信息/Info

Title:
Clinical characteristic analysis of 342 patients with coronary myocardial bridge
作者:
朱 超; 刘昱圻; 高 磊; 薛 桥; 田进文; 李 泱; 王 禹
(解放军总医院心血管病研究所，北京 100853)
Author(s):
ZHU Chao;  LIU Yu-qi;  GAO Lei;  XUE Qiao;  TIAN Jin-wen;  LI Yang;  WANG Yu
(Institute of Geriatric Cardiology, PLA General Hospital, Beijing 100853, China)
关键词:
冠状动脉; 心肌桥; 心绞痛; 预后
Keywords:
coronary artery;  myocardial bridge;  angina pectoris;  prognosis
分类号:
R541.4
DOI:
-
文献标识码:
A
摘要:
目的:探讨冠状动脉心肌桥的临床特点。方法： 2009年1月~2011年12月在我院住院的患者，通过冠脉CT或冠脉造影检查诊断心肌桥342例。结果： 其中表浅型232例，占67.8%。118例表浅型心肌桥患者伴有胸闷症状，61例深在型心肌桥患者伴有胸闷症状，无统计学差异；深在型肌桥患者心电图ST-T异常发生率较表浅型明显增高（P<0.05），两者患高血压病、糖尿病、高脂血症、心肌病发病率无统计学差异。深在型心肌桥较表浅型再发心绞痛发生率较高（P<0.05）。临床药物治疗包括倍他洛克、钙离子拮抗剂、硝酸酯、他汀、阿司匹林、氯吡格雷，两者间没有统计学差异，非药物治疗包括介入治疗和外科手术治疗。结论： 心肌桥并非罕见,心肌桥与临床心绞痛、动脉粥样硬化、心肌梗死、致死性心律失常有关。药物治疗包括β受体阻断剂、钙离子拮抗剂。外科治疗仍有争议，包括搭桥和肌桥松解术。
Abstract:
AIM:To evaluate the clinical characteristics of coronary myocardial bridge. METHODS: Included in the study were 342 patients who were hospitalized in our hospital from January 2009 to December 2011 and were diagnosed as having myocardial bridge according to coronary CT angiography (CTA) and coronary angiography. RESULTS: Among the patients, 232 cases (67.8%) were superficial type of whom 118 cases were accompanied by chest oppression, whereas 61/110 cases were of deep type accompanied by the same symptoms, with no statistical significance between types. The incidence of abnormal ST-T in electrocardiogram in deep type was statistically higher than in the superficial type (P<0.05). Incidence of hypertension, diabetes, hyperlipidemia and cardiomyopathy between superficial and deep types were not statistically different. During follow-up, the incidence of deep-type recurrent angina was statistically higher than in the superficial type (P<0.05). CONCLUSION: Myocardial bridge is not rare and may be associated with angina pectoris, atherosclerosis, myocardial infarction and lethal arrythmias. Medical treatment includes β-receptor blockers and calcium channel blockers. Surgical therapy includes myotomy and coronary artery bypass grafting (CABG); stenting is still controversial.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2013-07-03.基金顶目：国家自然科学基金项目资助（81100186/H0214）
通讯作者：刘昱圻，主治医师，主要从事冠心病研究Email：ametuofo980869@163.com
作者简介：朱超，硕士生Email：chao.mengxiang@qq.com
更新日期/Last Update: 2014-01-16