冠状动脉心肌桥临床分析

目的探讨冠状动脉心肌桥的临床意义及治疗。方法对我院2003年1月-2006年9月接受选择性冠状动脉造影的437例病例进行回顾性分析，共检出心肌桥8例。采用Judkins法进行选择性冠脉造影。结果心肌桥的检出率为1．83％，均为左前降支单发心肌桥，8例患者均有心绞痛症状，7例EKG、Holter检查有缺血性ST-T改变，但2例肌桥近段有粥样硬化及狭窄，3例心脏彩超有阳性发现。肌桥伴冠脉近段狭窄予药物治疗和PCI治疗，单纯肌桥者仅予药物治疗。结论冠状动脉心肌桥多发生于左前降支，可致心肌缺血或心肌梗死，肌桥近段血管易发生粥样硬化，β受体阻滞剂、非二氢吡啶类钙离子拮抗剂可缓解因心肌桥对壁冠状动脉的压迫所致的心绞痛。

Clinical analysis of patients with coronary myocardial bridge

Objective To evaluate the clinical significance and treatment of coronary myocardial bridge.Mechods 8 patients with myocardial bridge were identified after retrospective analysis of 437 patients taking selective coronary arteriography from Jan.2003 to Sep.2006 in Antu Hospital of Shanghai.The method of selective coronary angiography was Judkins'.Results The detected ratio of myocardial bridge was 1.83%.All these patients were over the left anterior descending(LAD) and had symptoms of anginal pectoris.7 patients had ST-T changes in EKG/Holter.2 patients had coronary atherosclerosis and stenosis detected in the segment proximal to the myocardial bridge.3 patients had positive signs in cardio-echo findings.Drugs and interventional techniques were used in patients of myocardial bridge with coronary stenosis.Patients of simple myocardial bridge were given drugs only.Conclusion Myocardial bridges are found most often at the left anterior descending coronary artery and are likely the cause of myocardial ischemia or myocardial infarct.Coronary atherosclerosis is easily generated in the segment proximal to the myocardial bridge.Beta-blockers and nondihydropyridines can relieve the angina pectoris caused by the myocardial bridge.