心肌桥致急性前壁心肌梗死的临床风险分析  

Clinical risk analysis on myocardial bridge leading to anterior wall acute myocardial infarction

作　　者：李虎 欧东波 刘迎雪 张殿新[2] 黄金燕 叶天扬 聂湘飞 黄淑程 

机构地区：[1]解放军第422医院心血管内科,广东湛江524005 [2]第四军医大学西京医院心血管内科,陕西西安710032

出　　处：《临床荟萃》2014年第9期965-968,共4页Clinical Focus

摘　　要：目的探讨心肌桥致急性前壁心肌梗死的特征及临床风险。方法统计因急性胸痛疑心肌梗死行造影检查检出心肌桥的30例患者以及因急性胸痛造影检查无心肌桥的30例患者,分析心肌桥与急性前壁心肌梗死的关系,以及心肌桥致急性心肌梗死的特点。结果两组患者性别、年龄、高血压、高脂血症、家族史、吸烟史方面比较差异均无统计学意义。心肌桥患者在胸闷和胸痛方面无特异表现。在硝酸甘油疗效方面,30例心肌桥患者中3例(10.0%)有疗效;而无心肌桥患者11例(36.7%)有疗效。另外,30例心肌桥患者25例(83.3%)心功能在Ⅲ级或者Ⅳ级,而无心肌桥患者18例(60.0%)心功能在Ⅲ级或者Ⅳ级;心肌桥患者最终16例(53.3%)发生心肌梗死,而无心肌桥患者有8例(26.7%)发生心肌梗死。结论心肌桥患者服用硝酸甘油疗效很差,心肌梗死的风险有所提高,应早期防治。Objective To explore the characteristics and the clinical risk of myocardial bridge leading to anterior wall acute myocardial infarction.Methods We enrolled 30 patients with myocardial bridge from PLA 422 Hospital and Xijing Hospital,together with 30 patients without myocardial bridge.The relationship between myocardial bridge and anterior wall acute myocardial infarction and the features of myocardial bridge leading to acute myocardial infarction were analyzed.Results We found that the two groups were not statistically significant in gender,age,hypertension,hyperlipidemia,family history,and smoking history.Both groups had the chest distress and same chest pain,but no specificity.However,in terms of the efficacy of nitroglycerin,out of 30 cases,3cases with myocardial bridging（10.0%）had effect;while 11 cases without myocardial bridge（36.7%）had effect.Also in 30 patients with myocardial bridge,there were 25cases（83.3%）with cardiac function NYHA Class Ⅲ orⅣ,and in 30 patients without myocardial bridge,there were 18cases（60.0%）with cardiac function NYHA ClassⅢorⅣ.In 30 cases with myocardial bridge,16cases（53.3%）had myocardial infarction ultimately,while in 30 patients without myocardial bridge,8cases（26.7%）had myocardial infarction and treatment.Conclusion The efficacy of nitroglycerin for patients with myocardial bridge is poor.Patients with myocardial bridging have a higher risk of myocardial infarction and should get early prevention.

关 键 词：心肌梗死 胸痛 血管成形术 经腔 经皮冠状动脉 

分 类 号：R543.3[医药卫生—心血管疾病]