应用血管内超声探讨前降支心肌桥与冠状动脉粥样硬化之间的相关性

发布时间：2018-05-16 19:57

本文选题：心肌桥 + 左前降支冠状动脉　；参考：《宁夏医科大学》2017年硕士论文

【摘要】：目的应用血管内超声探讨前降支心肌桥与冠状动脉粥样硬化之间的相关性。方法选取2013年6月至2016年12月期间就诊宁夏医科大学附属总医院和心脑血管医院心内科,并在导管室内行血管造影同时行血管内超声的患者共102例。前降支心肌桥合并冠状动脉粥样硬化患者50例为A组,前降支冠状动脉粥样硬化不合并心肌桥的患者52例为B组,进一步再将A组根据病变程度分为A1、A2和A3组,分别对比A组和B组以及A1、A2和A3组冠脉粥样硬化危险因素的差异。收集的所有数据均采用SPSS17.0统计软件包统一处理,计数资料用百分率表示,计量资料使用均数±标准差表示,所有结果检验标准为P0.05具有统计学意义。结果1、A组和B组结果比较:AB组两组在血脂异常上差异具有统计学意义(A组VS B组,48.00%VS 67.31%,P0.05),而且A组的总胆固醇、甘油三酯、低密度脂蛋白水平均低于B组(A组VS B组,3.78±1.17mmol/L VS 4.30±1.44mmol/L;1.88±1.17mmol/L VS 2.51±1.62mmol/L;2.31±1.02mmol/L VS 2.93±1.36mmol/L,P0.05),两组间差异具有统计学意义。而其他所测得的危险因素两组间差异在统计学上无意义(P0.05)。2、A1组、A2组、A3组之间结果比较:三组之间的心肌桥厚度水平A1组(0.39±0.14)、A2组(0.42±0.18)、A3组(0.58±0.22)和AC水平A1组(21.05±9.86)、A2组(23.14±9.3)、A3组(30.74±10.89)均呈逐渐递增的趋势,采用非参数检验,三组间差异不完全相等,具有统计学意义(P0.05)。对Max PB分别做和心肌桥厚度、AC相关性分析,P0.05,均呈显著性正相关。而其他所测得的危险因素三组间差异在统计学上无意义(P0.05)。3、另外,50例前降支心肌桥患者,经统计发现合并有粥样硬化斑块处共77处,MB近段血管50处(64.94%),肌桥部血管14处(18.18%),MB远段血管13处(16.88%),通过非参数检验分析可知,差异显著,具有统计学意义(P0.05)。结论1.心肌桥患者与无心肌桥患者相比,两者在形成相当量的斑块时,心肌桥患者可能需要较低浓度的血脂即可,即敏感性可能更高。2.前降支存在心肌桥的患者容易在心肌桥近段形成冠状动脉硬化斑块。3.心肌桥的厚度和肌桥对壁冠状动脉的压缩程度与冠状动脉狭窄程度呈正相关,提示心肌桥可能对冠状动脉粥样硬化的过程起着重要的影响作用。
[Abstract]:Objective to investigate the relationship between anterior descending myocardial bridge and coronary atherosclerosis by intravascular ultrasound. Methods from June 2013 to December 2016, 102 patients were admitted to the General Hospital of Ningxia Medical University and the Cardiovascular and Cerebrovascular Hospital. 50 patients with anterior descending coronary artery with coronary atherosclerosis and 52 patients with anterior descending coronary artery atherosclerosis without myocardial bridge were divided into two groups according to the degree of lesion. The risk factors of coronary atherosclerosis were compared between group A and group B, as well as group A 1 A 2 and group A 3. All the collected data were processed by SPSS17.0 statistical software package, the counting data were expressed by percentage, the measurement data were expressed by mean 卤standard deviation, and all the results were tested by P05 with statistical significance. Results 1Compared with group B, there were significant differences in blood lipid abnormalities between group A and group B. there were significant differences between group A and group A (vs group B, P 0.05, vs 67.31), and the total cholesterol and triglyceride in group A, and serum triglyceride (TG), total cholesterol (TC), triglyceride (TG), triglyceride (TG) in group A (P < 0.05). The level of low density lipoprotein in group A was lower than that in group B (3.78 卤1.17mmol/L vs 4.30 卤1.44 mmol / L, 1.88 卤1.17mmol/L vs 2.51 卤1.62 mmol / L, 2.31 卤1.36 mmol / L vs 2.93 卤1.36 mmol / L, P 0.05), and there was significant difference between the two groups. The difference of other risk factors between the two groups was not statistically significant. The results showed that the myocardial bridge thickness of group A 1 (0.39 卤0.14) was 0.42 卤0.18 (0.58 卤0.22) and that of AC A 1 was 21.05 卤9.86 (30.74 卤10.89), and that of A _ 2 and A _ (3) was increased gradually (P _ (0.05). 2A _ (2) A _ (2) and A _ (2) (0.39 卤0.14 卤0.14) A _ (3) and AC _ (A _ 1) (P _ (0.05) 卤(9.86) A _ (2) (30.74 卤10.89), respectively. Using non-parametric test, the difference between the three groups was not completely equal, with statistical significance (P 0. 05). The correlation between Max PB and myocardial bridge thickness (AC) was significant positive correlation (P 0.05). There was no statistically significant difference in other risk factors among the three groups. In addition, there were 50 patients with anterior descending myocardial bridge. It was found that there were 77 proximal vessels with atherosclerotic plaques in 50 vessels at 64.94 and 14 vessels in muscle bridge at 18.1818MB in 13 and 16.88 in the distal segment. The results of non-parametric analysis showed that the difference was significant, and the difference was statistically significant (P 0.05). Conclusion 1. Myocardial bridge patients may need lower serum lipids when they form a significant number of plaques compared with those without myocardial bridge patients, that is, the sensitivity may be higher. 2. Patients with anterior descending branch of myocardial bridge are prone to develop coronary atherosclerotic plaque. 3. 3 in the proximal segment of the myocardial bridge. The thickness of myocardial bridge and the degree of compression of myocardial bridge to mural coronary artery were positively correlated with the degree of coronary artery stenosis, suggesting that myocardial bridge may play an important role in the process of coronary atherosclerosis.
【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

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