冠状动脉造影检查对心肌桥的诊断价值

目的 探讨冠状动脉造影检查对心肌桥诊断的应用,研究心肌桥和冠状动脉粥样硬化的相关性.方法 收集1523例患者冠状动脉造影检查资料,分析心肌桥检出率,观察心肌桥的发生位置、壁冠状动脉收缩期狭窄程度、心肌桥血管合并粥样斑块的位置、斑块处管腔狭窄程度.结果 全部1523例患者中,201例患者检查结果正常,1225例患者检出粥样斑块,231例患者检出心肌桥.心肌桥检出率为15.2％,共检出心肌桥235处.心肌桥位置：右冠状动脉1处,左主干1处,旋支1处,对角支3处,左前降支229处,以左前降支中段多见,壁冠状动脉收缩期轻度狭窄为主.纯心肌桥97例.134例患者心肌桥血管合并粥样斑块144处,斑块位置：心肌桥近端111处,心肌桥段19处,心肌桥远端14处.心肌桥近端血管粥样硬化较心肌桥段、心肌桥远端发生率高,但粥样斑块的形成与壁冠状动脉收缩期的狭窄程度无显著相关（P＞0.05）.结论 心肌桥多见于左前降支中段血管,壁冠状动脉收缩期多为轻度狭窄,血管合并粥样硬化,多见于心肌桥前端,但粥样斑块的形成与壁冠状动脉收缩期狭窄程度无明显相关性.冠状动脉造影检查对心肌桥及心肌桥合并粥样硬化的诊断有重要价值.

Value of coronary angiography in diagnosticating myocardial bridge

Objective To investigate the application of coronary angiography in diagnosticating myocardial bridge, research the relationship between myocardial bridge and coronary atherosclerosis. Methods To collect 1523 patients＇ coronary angiography data, analyse the detection rate of myocardial bridge, observe the occurrence location of myocardial bridge and degree of mural coronary artery stenosis in systole and the location of atheromatous plaque in myocardial bridge blood vessel and the degree of lumen stenosis in plaques, compare their results. Results In the all patients, the inspection results of 201 patients were normal, and 1225 patients were atheromatous plaque, and 231 patients were myocardial bridge. The detection rate of myocardial bridge was 15.2%. In totally,235 myocardial bridges were detected, the position of these myocardial bridges ： there was 1 in right coronary artery, 1 in left main coronary artery, 1 in circumflex branch, and there were 3 in diagonal branch, 229 in left anterior descending coronary artery and they were more common in midpiece left anterior descending artery. It was main of mural coronary artery with mild stenosis in systole. There were 97 patients detected myocardial bridge without atherosclerosis. 134 cases were detected 144 atheromatous plaques in myocardial bridge blood vessel,and the location of these plaques ： there were 111 in proximal myocardial bridge, 19 in myocardial bridge, 14 in distal myocardial bridge. The incidence rate of blood vessel scleratheroma in proximal myocardial bridge was higher than in myocardial bridge and distal myocardial bridge. However, there was not significant correlation between the formation of atheromatous plaque and degree of mural coronary artery stenosis in systole （ P 〉 0.05 ）. Conclusion Myocardial bridge is more common in midpiece blood vessel of left anterior descending artery, mural coronary artery mainly had with mild stenosis in systole. Blood vessel scleratheroma is more common in proximal myocardial bridge. But, there was not evident relationship between the formation of atheromatous plaque and degree of mural coronary artery stenosis in systole. There is important value of coronary angiography in diagnosticating myocardial bridge and myocardial bridge combined with atherosclerosis.