冠状动脉造影检出心肌桥91例分析

目的探讨心肌桥（MB）的冠状动脉造影及临床特征。方法回顾分析5209例冠状动脉造影中检出的91例MB病例的冠状动脉造影及临床特点，分析MB与冠状动脉粥样硬化及缺血性心脏事件的关系。结果MB检出率1．75％，其中左冠状动脉前降支MB86例，对角支4例，回旋支1例，孤立性MB患者75例。91例中，31例无典型临床症状，44例表现为心绞痛等临床症状，8例MB近段有粥样硬化病变，7例MB合并其他冠脉血管的粥样硬化，1例MB合并肥厚型心肌病。结论MB有促进其近段血管发生粥样硬化病变的可能；MB的狭窄程度越严重，引起心肌缺血越严重。

Analysis of 91 patients with myocardial bridges detected with coronary angiography

Objective To discuss the angiographic features and clinical significance of coronary myocardial bridge(MB).Methods The angiographic features and clinical significance were retrospectively analyzed in 91 patients who were identified to have MB from 5209 patients receiving coronary artery angiography(CAA),and the relationship between MB and coronary atherosclerosis,myocardial ischemia were analyzed.Results The incidence of MB in this group was 1.75%(91/5209).Among these 91 patients,86 MB located at the left anterior descending artery,4 at diagonal artery,and 1 at left circumflex artery.In 75 cases with isolated MB,31 cases had no remarkable symptoms,whereas 44 showed clinical symptoms of angina pectoris.Eight patients had atherosclerosis in the proximal coronary arteries to MB.MB was complicated by atherosclerosis located at other coronary arteries in 7 cases and by hypertrophic myocardial disease in 1 case.Conclusion MB tends to accelerate the atherosclerosis in proximal segment vessels,of the more severe the extent of systolic diameter stenosis,the more severe the myocardial ischemia.