冠状动脉心肌桥及其临床意义

目的　探讨冠状动脉造影的病人中心肌桥的发生率及其临床意义。方法和结果　 2 557例行冠状动脉造影术的人群中 ,共检出心肌桥 1 7例 ,发生率为 0 665% ,均为左前降支心肌桥。收缩期狭窄程度 >50 %的有 1 4例 ,均有心绞痛症状 ,心电图提示有ST段移位、T波改变等心肌缺血表现 ;5例行心肌核素显像的病人提示有前壁心肌缺血。有 1例患者为陈旧前壁心肌梗塞 ,心肌桥于收缩期致 1 0 0 %血流阻断。 1 7例病人中有 3例左心室造影提示有室壁肥厚。结论　冠状动脉造影中的心肌桥现象并非罕见。心肌桥的存在可引起心肌缺血及相应的心电图、核素心肌显像缺血改变 ,严重的心肌桥压迫可引起心肌梗塞。

Coronary myocardial bridge and its clinical implication

Objectives To assess the prevalence of coronary myocardial bridge in the population of patients under went diagnostic coronary angiography and its clinical implication Methods and Results Among 2 557 coronary angiograms performed in the First Hospital of Beijing Medical University 17 patients had myocardial bridges over the left anterior descending arteries The total prevalance of myocardial bridges was 0 665% Among these patients,14 patients had systolic narrowing of coronary artery of >50 percent with angina pectoris and ischemic finding in electrocardiogram Nuclide myocardial perfusion imaging showed anterior wall myocardial ischemia in 5 patients One patient who was diagnosed old anterior myocardial infarction,revealed LAD systolic total occlusion Three patients were showed myocardial hypertrophy by left ventriculogram Conclusion The prevalance of coronary myocardial bridging in the studied coronary angiographic population was 0 665% Myocardial bridge could be responsible for myocardial ischemia and myocardial infarction