冠状动脉前降支心肌桥近端粥样硬化狭窄的危险因素  

The risk factors for atherosclerotic stenosis in the proximal mural coronary artery of the anterior descending segment

作　　者：张刚[1] 桂鸣[1] 唐立钧 杨志健[1] 曹克将[1] 

机构地区：[1]南京医科大学第一附属医院心内科 [2]放射科,江苏南京210029

出　　处：《中华高血压杂志》2012年第10期975-978,共4页Chinese Journal of Hypertension

基　　金：江苏高校优势学科建设工程项目(JX10231081)

摘　　要：目的探讨前降支冠状动脉心肌桥患者桥前发生动脉粥样硬化狭窄的可能危险因素。方法收集2010-07-2011-09因胸闷、胸痛等原因在南京医科大学第一附属医院住院期间接受双源CT检查,左前降支冠状动脉存在心肌桥的患者383例,平均年龄64.4岁,男性占56.1%。根据是否伴有桥-壁冠状动脉近端狭窄分为伴有(A组,n=221)和未伴有(B组,n=162),收集两组患者心肌桥长度、心肌桥压迫程度和年龄、性别、高血压、糖尿病病程、血脂异常、吸烟等因素。结果与B组比较,A组心肌桥压迫程度更严重[(51.3±15.8)%比(34.0±18.7)%,P<0.01]。以前降支心肌桥近端狭窄为因变量,近端狭窄的可能危险因素为自变量进行多因素Logistic回归分析,结果显示:年龄(OR1.109,95%CI1.075～1.145)和心肌桥压迫程度(OR1.084,95%CI1.065～1.103,均P<0.05)与桥-壁冠状动脉近端发生狭窄独立相关。结论年龄和心肌桥压迫程度是桥-壁冠状动脉近端发生狭窄的危险因素。Objective To explore the possible risk factors for atherosclerotic stenosis in the proximal mural coronary artery of the anterior descending segment. Methods The present study included 383 inpatients, with the mean age of 64.4 years old and 56.1 percent male, in which myocardial bridge over the left anterior descending coronary artery （LAD） found on Dualsource CT performed in the the First Affiliated Hospital of Nanjing Medical University because of chest pain or distress between July 2010 and September 2011. The patients were divided into two groups based on whether suffering from atherosclerotic stenosis in the proximal mural coronary artery or not, and there were 221 patients with stenosis in group A, and 162 patients without stenosis in group B. Patients＇ age, gender, the history of hypertension, the course of diabetes, dyslipidemia, smoking were recorded, as well as the length of myocardial bridge and the degree of the pressure on the mural coronary artery. Results Compared with group B, the degree of the pressure from myocardial bridge [（51.3±15.8）%vs （34.0±18.7） %, P〈0.01] in group A was more. When the proximal mural coronary artery atherosclerotic stenosis in the LAD was defined as a dependent variable, the multivariate Logistic regression analysis showed that age （OR= 1. 109, 95 % CI 1. 075-1. 145, P〈0.05） and the degree of the pressure from myocardial bridge （OR=1. 084, 95% CI 1. 065-1. 103, P〈0.05） were included an independent risk factors. Conclusion Age and the degree of the pressure from myocardial bridge are risk factors for atherosclerotic stenosis in the proximal mural coronary artery.

关 键 词：双源CT 心肌桥 粥样硬化 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]