心肌桥对冠状动脉血流储备的影响  

The impact of myocardial bridge on coronary flow reverse

作　　者：张国辉[1] 钱菊英[1] 樊冰[1] 王齐冰[1] 颜彦[1] 严卫[1] 王灏[1] 路艳[1] 冯琪[1] 葛均波[1] 

机构地区：[1]上海市心血管病研究所复旦大学附属中山医院心内科,200032

出　　处：《中华心血管病杂志》2002年第5期279-281,共3页Chinese Journal of Cardiology

摘　　要：目的　探讨心肌桥对冠状动脉血流储备的影响。方法　对 16例经冠状动脉造影诊断有心肌桥者作冠状动脉内多普勒检查 ,观察并记录壁冠状动脉及其远近段血流图形及特点 ,壁冠状动脉远段、近段的基础平均峰值流速 (bAPV)和充血平均峰值流速 (hAPV) ,分别计算出壁冠状动脉远段、近段的血流储备 (CFR)并予比较 ,作配对t检验。CFR定义为冠状动脉相同节段hAPV和bAPV的比值。结果　 16例患者的心肌桥均位于左前降支 ,其壁冠状动脉多普勒频谱血流图形呈特征性的舒张早期指尖样变化 ,壁冠状动脉近段和远段bAPV无明显差异 [(18 8± 9 2 )cm/s比 (17 5± 7 8)cm/s,P>0 0 5 ],而hAPV的增加明显高于其远段 [(5 5 5± 19 5 )cm/s比 (4 1 1± 17 9)cm/s,P <0 0 5 ]。壁冠状动脉近段CFR明显高于其远段 (3 13± 1 15比 2 38± 0 76 ,P <0 0 1)。结论　心肌桥使壁冠状动脉的多普勒血流图形呈特征性指尖样现象 ,其远段CFR下降 。Objective To evaluate the impact of myocardial bridge on coronary flow reserve Methods The intracoronary Doppler flow measurement was performed in 16 cases with myocardial bridge The characteristic of intramural coronary flow pattern, basic average peak velocity (bAPV)and hyperemic average peak velocity(hAPV),both proximal and distal flow to intramural coronary segment and the coronary flow reverse(CFR)of these segments were studied CFR was defined as the ratio of the hAPV to bAPV Results The myocardial bridges were all located in the left anterior descending artery A typical fingertip phenomenon in early diastolic period, was seen in intramural coronary segment There was no obvious difference on the everage of bAPV between the proximal segments and the distal segments [(18 8±9 2)cm/s vs (17 5±7 8)cm/s, P >0 05], but the proximal hAPV was significantly higher than distal hAPV [(55 5±19 5)cm/s vs (41 1±17 9)cm/s, P <0 05] The distal CFR was reduced and significantly lower than the proximal CFR (3 13±1 15 2 38±0 76, P <0 01) Conclusion A typical early diastolic fingertip phenomenon of Doppler flow pattern was seen within intramural coronary segment The distal CFR was reduced and significantly lower than the proximal CFR

关 键 词：心肌桥 冠状动脉血流储备 冠状动脉循环 冠心病 血流图 多普勒血流图 

分 类 号：R542.202[医药卫生—心血管疾病]