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1、冠狀動(dòng)脈肌橋的造影特點(diǎn)及臨床治療分析【摘要】「【的探討冠狀動(dòng)脈造影人群屮冠狀動(dòng)脈橋的造影特點(diǎn)及臨床治療方法。方法回顧性分析接受選擇性冠狀動(dòng)脈造影1058例患者的臨床資料。結(jié)果在1058例行選擇性冠狀動(dòng)脈造影人群中,發(fā)現(xiàn)冠狀動(dòng)脈心肌橋67例(6.3%),64例發(fā)生于左前降支(LAD),僅2例見于左冋旋支(LCX),1例見于右冠;收縮期狹窄>50%的有35例,收縮期狹窄>75%有17例;14例有典型心絞痛癥狀,51例癥狀不典型,2例為心肌梗死患者,所有患者均應(yīng)用B受體阻滯劑及鈣通道阻滯劑治療,其中孤立性心肌橋患者中有20例患者癥狀明顯改善;合并單支病變36例患者以及合并雙支病變的
2、10例患者對狹窄的靶血管行PCI術(shù)后給予3受體阻滯劑及鈣通道阻滯劑治療,患者癥狀明顯改善。結(jié)論心肌橋常見于LAD,常引起典型的心絞痛,鈣離子拮抗劑及P受體阻滯劑可緩解癥狀。極少數(shù)病例需行PCI及外科手術(shù)治療?!娟P(guān)鍵詞】心肌橋;冠狀動(dòng)脈;心絞痛AngiographicFeaturesandClinicalTreatmentofCoronaryMyocardialBridgeHUXiaofeng,LIUWei,ShenyangMilitaryGeneralHospital,Shenyang,LiaoningProvince110016ABSTRACTObjectiveTodisc
3、usstheangiographicfeaturesandclinicaltreatmentofcoronarymyocardialbridge(CMB).MethodsAretrospectiveanalysiswasmadetotheclinicaldataof1058casesreceivingselectedcoronaryarteriongraph(CAG).Resu1tsOutofthe1058cases,CMBwasfoundin67cases(6.3%),amongwhich,64casesintheleftanteriordescending(LAD),2c
4、asesinLCXandleaseintherightaeteriacoronaria;35caseshadcoronarystystolicstenosisgreaterthanorequalto50%while17casesgreaterthanorequalto70%;14casesshowedouttypicalsymptomsofanginapectorisand51casesshowedoutatypicalones,2caseshadmyocardialinfarction;allpatientsreceivedthetreatmentofβrecep
5、torblockagentandcalciumantagonblockagent,20caseswithisolatedmyocardialbridgeshowedobvioussymptomimprovementaswellas36caseswithsinglebranchlesionand10caseswithdoublebranchlesionreceivingpercutaneouscoronaryintervention(PCI)beforethetreatment.ConclusionMyocardialBridgeisoftenfoundinLAD,whichc
6、ausestypicalsymptomofanginapectoris;CalciumantagonandβreceptorblockagentareeffectiveinrelievingthesymptomofCMB;FewcasesneedPCIorsurgery?KEYWORDSmaocardialbridgecoronaryarteryanginapectoris正常情況下,冠狀動(dòng)脈及其分支走行于心外膜下心肌表而。當(dāng)冠狀動(dòng)脈或其分支的某個(gè)節(jié)段行走于室儲心肌纖維之間,被形似橋的心肌纖維覆蓋,在心臟收縮時(shí)出現(xiàn)暫吋性管腔狹窄其至閉塞,則被心肌纖維覆蓋的動(dòng)脈段稱為
7、舉冠狀動(dòng)脈,這段心肌纖維稱為冠狀動(dòng)脈心肌橋(簡稱心肌橋,myocardialbridging,MB)。近年來,隨著冠狀動(dòng)脈造影(CoronaryArteryAngiography)的普遍開展,心肌橋的基礎(chǔ)及臨床研究有了深入的發(fā)展。本文通過回顧性分析,結(jié)合有關(guān)文獻(xiàn),對心肌橋的冠狀動(dòng)脈造彩特點(diǎn)做一分析,并對冠狀動(dòng)脈肌橋的治療進(jìn)行探討。1資料與方法1.1對象我院心導(dǎo)管室自2005年7月?2006年7月完成的冠脈造影1058例,共檢出心肌橋67例,年齡39?81(53.1()±13.13)歲,其中男41例,女2