壁冠状动脉心肌桥的造影和临床分析  

Clinical analysis and coronary angiography of coronary myocardial bridge

作　　者：刘利军[1,2] 张爱萍[2] 潘文麒[1] 

机构地区：[1]上海交通大学医学院附属瑞金医院心血管内科,上海200025 [2]淮南市第一人民医院心血管内科

出　　处：《内科理论与实践》2009年第1期41-44,共4页Journal of Internal Medicine Concepts & Practice

摘　　要：目的:观察、分析壁冠状动脉(冠脉)和心肌桥的临床特点与诊断、治疗方法。方法:观察、分析经冠脉造影确诊的96例109处心肌桥患者的心肌桥分布特点、临床症状、心电图、心肌酶谱、肌钙蛋白T、心脏超声,评价药物或支架治疗心肌桥的疗效。结果:心电图、临床症状、心肌酶谱、肌钙蛋白T和心脏超声对心肌桥的诊断均无特异性。造影发现93.7%的心肌桥发生于冠脉前降支(LAD)。心肌桥患者临床症状与收缩期狭窄程度有关。药物治疗、手术治疗均有一定疗效。结论:冠脉造影发现"收缩期狭窄"为目前确诊心肌桥的主要方法。心肌桥与心绞痛、动脉粥样硬化、心肌梗死的发生有密切关系。药物治疗可选用肾上腺素β受体阻滞剂和Ca2+拮抗剂。Objective To observe and analysis the clinical characteristics of intramural coronary artery and myocardial bridge and to assess the diagnosis and treatment of coronary myocardial bridge. Methods Clinical symptoms, electro- cardiogram （ECG）, myocardial enzyme spectrum, troponin T and eehocardiography were observed and analyzed in 96 patients with 109 myocardial bridges diagnosed by coronary artery angiography.The theraputic efficacy of drug and stent was assessed. Results ECG, clinical symptoms, myocardial enzyme spectrum, troponin T and echocardiography were not specific for the diagnosis of myocardial bridge. Coronary angiography demonstrated that 94.7% of myocardial bridges were found in the left anterior descending artery（LAD）. The clinical symptoms were correlated with the degree of systolic stenosis. Drug and stent therapy had definite therapeutic effect. Conclusions Currently, myocardial bridge is diagnosed predominantly by systolic stenosis illustrated by coronary augiography. Myocardial bridge has close relation with angina pectoris, atherosclerosis and myocardial infarction. Calcium antagonists and beta receptor blocking agents could be selected for the drug therapy of coronary myocardial bridge.

关 键 词：壁冠状动脉 冠状动脉造影 心肌桥 

分 类 号：R541.1[医药卫生—心血管疾病]