有症状心肌桥患者药物治疗与心肌松解术疗效分析

目的研究有症状心肌桥患者行药物治疗和心肌松解术两者间的疗效。方法选取我院2012年6月至2014年6月心外科有明显心绞痛症状的住院患者共50例,且冠脉造影确诊为心肌桥,所有患者加拿大心功能分级(CCS)为Ⅱ~Ⅳ级,分为2组,其中一组行心肌桥松解术(治疗组),共26例患者;另一组使用β受体阻滞剂和/或钙离子拮抗剂(CCB)类药物保守治疗(对照组),共24例患者。随访1年后,以心肌梗死、死亡、靶血管重构及CCS心绞痛评分>2分为观察终点事件。结果两组患者的基线特征,包括性别、年龄、CCS分级、合并高血压、糖尿病等比较差异均无统计学意义(P>0.05)。两组患者病变血管直径、压缩比例及狭窄程度比较差异无统计学意义(P>0.05)。平均随访12个月后,治疗组患者终点事件发生率明显低于对照组,差异有统计学意义(P>0.05)。结论心肌松解术对有症状的心肌桥患者预后明显好于药物保守治疗。

Effect of drug therapy and cardiac muscle relaxation on patients with symptomatic myocardial bridge

Objective To study the curative effect of drug therapy and cardiac muscle relaxation on patients with symptomatic myocardial bridge. Methods Fifty patients with obvious symptoms of angina pectoris who were di-agnosed with myocardial bridge by coronary angiography from June 2012 to June 2014 in our hospital with heart func-tion of gradeⅡtoⅣby CCS were divided into 2 groups:treatment group (n=26) was treated with cardiac muscle re-laxation and control group (n=24) was treated with beta blockers and/or calcium antagonist (CCB). After 1 year of follow-up,the outcome was observed in patients with myocardial infarction, death, target vessel remodeling and CCS score>2. Results The baseline characteristics of the two groups (including gender,age,CCS grades,hypertension and diabetes) were not significantly different ( P>0. 05 );there was no significant differences between the two groups re-garding lesion vessel diameter and compression ratio (P>0. 05). After an average 12-month follow-up,the treatment group was significantly lower on the end-point incidence than control group (P<0. 05). Conclusion Cardiac muscle relaxation has better prognosis for patients with symptomatic myocardial bridge than the conservative drug treatment.