冠状动脉心肌桥138例临床研究

目的研究冠状动脉造影病人中心肌桥的临床特征以及发生率。方法用Jukins法行选择性冠状动脉造影术，心肌桥的造影判断是冠状动脉收缩期短暂、间歇狭窄，而于舒张期恢复或狭窄程度明显减轻。本研究中将狭窄程度≥70％、50％～70％、〈50％划分为3组。结果3356例行选择性冠状动脉造影术的人群中，共检出心肌桥138例，发生率为4．11％。均为左冠状动脉前降支（LAD）心肌桥。位于LAD远段22例，中段114例，近段2例。无心脏病的孤立心肌桥100例，伴有冠心病的心肌桥26例，伴有瓣膜病6例，伴有心肌病例6例。孤立心肌桥中收缩期冠状动脉狭窄程度I〉70％50例，50％-70％34例，〈50％16例。138例心肌桥中超声心动图或左心室造影提示有室壁肥厚26例。心电图提示有ST．T改变36例；孤立心肌桥中有胸痛症状50例；行运动负荷试验阳性36例。结论冠状动脉造影是心肌桥的可靠检出手段。心肌桥可伴随其他心脏病发生，也可孤立存在。

Cinical analysis of 138 cases of coronary myocardial bridge

Objective To assess the prevalence of coronary myocardial bridge in patients underwent diagnostic angiography and its clinical features. Methods We law underwent selective coronary angiography by using Jukins. The myocardial bridge angiography features are short-term, intermittent narrow systole while the diastolic recovery or significantly reduced. This study grouped three according to the narrow degree： ≥ 70% ,50% to 70% and 〈 50%. Results Among 3356 cases with coronary angiograms in the Cardiology Department, Suining Central Hospital, 138 Patients had myocardial bridge over the left anterior descending arteries. The total prevalence of myocardial bridges was 4.11%. Among these patients, 26 suffered from coronary artery disease, 6 had valvular heart disease, 6 had cardiomyopathy,and 100 had isolated myocardial bridges. Among the patients with isolated myocardial bridge,50 had 〉70% systolic narrowing of coronary artery 34 had 50% - 70%, 16 had 〈 50%. Among 100 patients with isolated myocardial bridges,50 had chest pain and 36 had ST-T abnormality in electrocardiogram. Twenty-six patients were showed myocardial hypertrophy by left ventriculogram or echocardiogrm. Conclusions Myocardial bridge could be revealed by Coronary angiography. Coronary myocardial bridge canpexist alone or along with other heart diseases.