冠状动脉心肌桥临床分析

目的探讨选择性冠状动脉造影人群中冠状动脉桥的发生率、临床特点及治疗。方法回顾性分析总结我院2005年1月~10月接受选择性冠状动脉造影1290例的临床资料。结果在1290例行选择性冠状动脉造影人群中,共发现冠状动脉心肌桥82例(6.3%),主要发生于左前降支(LAD),仅1例见于左回旋支(LCX)。收缩期狭窄≥50%的有30例,其中收缩期狭窄≥75%有9例。43例有典型心绞痛症状,其中36例应用倍他乐克或硫氮卓艹酮后临床症状消失或缓解,2例重度心肌桥行冠状动脉内支架置入术。结论冠状动脉心肌桥多发生于LAD,可致典型心绞痛症状,治疗上可应用β受体阻滞剂或钙离子拮抗剂,极少病例需冠状动脉内支架置入术,或外科采用心肌桥松解术。

Clinical Analysis of Coronary Myocardial Bridge

Objective To investigate the incidence, clinical feature and therapeutics of coronary myocardial bridge (CMB) in patients undergone coronary arteriography (CAG). Methods The clinical data of 1 290 cases with CAG were analyzed retrospectively. Results Among 1 290 cases, 82 cases were with CMB (6.3%). CMB was mainly found in the left anterior descending (LAD). There were 30 cases with coronary systolic stenosis greater than or equal to 50%, in which 9 cases greater than or equal to 75%. 43 cases were with typical symptom of angina pectoris, in which 36 cases were improved by metoprolol and diltiazem, 2 cases with severe CMB received percutaneous coronary intervention (PCI). Conclusions CAM are usually found in LAD, and it can lead to typical symptom of angina pectoris. Calcium antagon and beta receptor blocking agent are effective for CMB. Few cases need PCI or surgical procedure.