心肌桥的临床特征及其影像学指标与心肌缺血症状的相关性

发布时间：2018-04-28 15:19

本文选题：心肌桥 + 壁冠状动脉　；参考：《中国动脉硬化杂志》2017年01期

【摘要】：目的用冠状动脉CT血管成像(CTA)和冠状动脉造影(CAG)检查心肌桥-壁冠状动脉(MB-MCA),探讨MB-MCA的临床特征及其影像学指标与心肌缺血症状的相关性。方法回顾分析我院近年来的MB病例,入选既经冠状动脉CTA又经CAG诊断的MB病例152例。按照有无动脉粥样硬化(As)分为单纯MB组、As并MB组;根据有无心肌缺血症状分为有症状组、无症状组。分析并比较各组临床特征及影像学资料。分析MB-MCA影像学指标与心肌缺血症状的相关性。结果冠状动脉CTA对MB的检出率为11.4%,CAG对MB的检出率为10.1%,两者相近。152例MB-MCA特点:收缩期压缩程度为50.1%±10.5%,舒张期压缩程度为22.8%±10.5%;平均长度为18.2±11.5 mm,厚度为2.7±0.8 mm;最常见MB发生部位为左前降支(LAD)中段(60.7%)。As并MB组心肌缺血症状(典型胸闷等)发生率、活动平板运动试验阳性率明显高于单纯MB组(75.5%比58.7%,66.0%比43.5%,P0.001)。有症状组比无症状组MB更多分布于LAD中段(86.9%比68.9%,P0.001),更易合并As发生(74.8%比57.8%,P0.001)。Spearman相关分析显示,MB厚度、MCA收缩期及舒张期压缩程度与心肌缺血症状呈显著正相关。结论冠状动脉CTA与CAG对MB的检出率相似。MB合并As患者的心肌缺血症状发生率、活动平板运动试验阳性率均高于单纯MB患者。MB患者心肌缺血症状与MB厚度、MCA压缩程度及As密切相关。
[Abstract]:Objective to investigate the clinical features of MB-MCA and its correlation with myocardial ischemic symptoms by detecting MB-MCAG of myocardial bridge-wall coronary artery with coronary CT angiography (CT) and coronary angiography (CAG). Methods the MB cases in our hospital in recent years were retrospectively analyzed. 152 MB cases diagnosed by coronary artery CTA and CAG were selected. According to whether there was atherosclerosis or not, the rats were divided into MB group and MB group, and were divided into symptomatic group and asymptomatic group according to the symptoms of myocardial ischemia. The clinical features and imaging data of each group were analyzed and compared. To analyze the correlation between MB-MCA imaging parameters and myocardial ischemic symptoms. Results the detection rate of MB in coronary artery was 11.4%. The detection rate of MB in coronary artery was 10.1. The characteristics of MB-MCA were similar: the degree of systolic compression was 50.1% 卤10.5mm, the degree of diastolic compression was 22.8% 卤10.5mm, the average length was 18.2 卤11.5 mm, the thickness was 2.7 卤0.8 mm, and the most common part of MB was found. The incidence of myocardial ischemia symptoms (typical chest tightness, etc.) in the MB group was 60.7% in the middle segment of left anterior descending branch (LAD). The positive rate of treadmill exercise test was significantly higher than that of MB group (75.5% vs 58.7%, 66.0% vs 43.5%, P 0.001). MB in symptomatic group was more distributed in middle segment of LAD than that in asymptomatic group (86.9% vs 68.9%, P 0.001), and it was more likely to be associated with as (74.8% vs 57.8%). Spearman correlation analysis showed that the thickness of MB and the degree of systolic and diastolic compression of MCA were positively correlated with myocardial ischemia symptoms. Conclusion the detection rate of MB in coronary CTA and CAG is similar. The incidence of myocardial ischemia symptoms in patients with MB and as is similar. The positive rate of treadmill exercise test was significantly higher than that of MB patients. The myocardial ischemic symptoms were correlated with the degree of MCA compression and as.
【作者单位】：武汉大学中南医院心内科;武汉大学中南医院放射科;
【基金】：湖北省自然科学基金(2013CFB246)
【分类号】：R541

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