经血管内超声观察左前降支心肌桥的特点

发布时间：2018-05-07 01:00

本文选题：血管内超声 + 肌桥　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的经血管内超声(IVUS)观察左前降支(LAD)心肌桥(MB)的特点。方法选择经冠状动脉造影(CAG)确诊的50例LAD MB患者行IVUS检查,通过超声影像分析仪对MB位置、MB长度、MB厚度、各段血管外弹力膜面积(EEMA)、管腔面积(LA)、血管内斑块面积(PA)、斑块负荷(PB)、血管重构指数(RI)、斑块长度、斑块厚度、斑块偏心指数(EI)进行分析。结果 1.LAD MB位于中段33例、远段17例。2.MCA的收缩程度与MB近段的斑块狭窄程度呈正相关(r=0.273,P0.05)。MCA的压缩程度与MB长度无相关性(r=0.237,P0.05),与MB厚度无相关性(r=0.117,P0.05);MB自身长度与厚度间也无相关性(r=0.181,P0.05)。MB的压缩程度与年龄、LVEF、TG、TC、HDL-C、LDL-C、FBG、HB、PLT、CREA无相关性(P0.05)。3.男性是Nobel分级的独立预测因子(P0.05)。4.斑块位于MB近段50例,MCA 15例,MB远段20例。MB近段斑块数量与MCA、MB远段相比,均有统计学差异(均P0.001),MCA与MB远段的斑块数量无明显差异(P0.05)。5.MB近段血管正性重构17例,MCA及MB远段血管均未见正性重构;MB近段血管负性重构22例,MCA及MB远段分别为10例、12例。MB近段正性重构血管段数与MCA和MB远段相比,其差异均有显著性(均P0.05);MB近段负性重构血管段数与MCA段相比有显著性差异(P0.05),与MB远段相比无显著性差异(P0.05),MCA段与MB远段也无显著性差异(P0.05)。6.50例患者MB近段均有斑块形成(其中偏心性斑块44例,向心性斑块6例),MCA段15例有斑块(均为偏心性斑块),MB远段20例有斑块(均为偏心性斑块)。MB近段斑块数量较MCA和MB远段斑块数量增多,其差异有统计学意义(均P0.001),MCA与MB远段斑块数量无统计学差异(P0.05)。不同性质的斑块在各段血管间无统计学差异(均P0.05)。7.MB近段与MCA比较,其EEMA[(19.06±5.926mm~2)vs(6.30±1.995mm~2)]、PA[(9.52±3.42mm~2)vs(4.92±2.177mm~2)]、PB[(64.37±12.921%)vs(50.07±10.498%)]、斑块长度[(39.94±13.401mm)vs(8.08±3.719mm)]、斑块厚度[(1.43±0.485 mm)vs(0.92±0.343mm)]间均存在统计学差异(均P0.05);MB近段与MB远段比较,其EEMA[(19.06±5.926mm~2)vs(9.74±4.066mm~2)]、PA[(9.52±3.42mm~2)vs(3.55±1.522 mm~2)]、PB[(64.37±12.921%)vs(44.08±12.889%)]、斑块长度[(39.94±13.401mm)vs(11.11±6.508mm)]、斑块厚度[(1.43±0.485mm)vs(0.76±0.330mm)]间均存在统计学差异(均P0.05)。MCA与MB远段比较,其EEMA[(6.30±1.995mm~2)vs(9.74±4.066mm~2)]间有统计学差异(P0.05),PA[(4.92±2.177mm~2)vs(3.55±1.522mm~2)]、PB[(50.07±10.498%)vs(44.08±12.889%)]、斑块长度[(8.08±3.719mm)vs(11.11±6.508mm)]、斑块厚度[(0.92±0.343mm)vs(0.76±0.330mm)]间均无统计学差异(均P0.05)。LA在三组血管间相比无统计学差异[MB近段为(5.24±2.365mm~2)、MCA段为(4.75±1.985mm~2)、MB远段为(4.37±1.435 mm~2)],均P0.05。结论 1.LAD MB多位于中段。2.MB导致的血管病变以MB近段为主。3.MB近段斑块的狭窄程度与MCA收缩程度呈正相关。4.男性是Nobel分级的独立预测因子。
[Abstract]:Objective To study the characteristics of left anterior descending coronary artery ( LAD ) myocardial bridge ( MB ) by intravascular ultrasound ( IVUS ) . There was no correlation between the degree of compression of MCA and MB length ( r = 0.237 , P0.05 ) . There was no correlation with the thickness of MB ( r = 0.117 , P0.05 ) . There was no correlation between the length and thickness of MB ( r = 0.181 , P0.05 ) . There was no significant difference in the number of MB proximal segments ( P0.05 ) . There was no significant difference in the number of MB proximal segments ( P0.05 ) . There was no significant difference in the number of segments in the proximal segment of MB ( P0.05 ) . There were no significant differences between the number of segments in the proximal segment of MB and the distal segment of MB ( P0.05 ) . There was no statistical difference between the three groups ( 4.92 卤 1.995mm ~ 2 ) vs ( 11.11 卤 6.508mm ) vs ( 11.11 卤 6.508mm ) vs ( 4.37 卤 1.435 mm ~ 2 ) vs ( 4.37 卤 1.435 mm ~ 2 ) vs ( 4.37 卤 1.435 mm ~ 2 ) vs ( 4.37 卤 1.435 mm ~ 2 ) vs ( 4.37 卤 1.435 mm ~ 2 ) .

【学位授予单位】：宁夏医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R541.4

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