单纯左前降支心肌桥对心肌供血影响的观察

摘要

目的 分析单纯冠状动脉左前降支心肌桥病变对心肌供血的影响.方法 90例研究对象按冠状动脉造影特征分为3组:单纯冠状动脉左前降支心肌桥组(A组),单纯冠状动脉左前降支狭窄组(B组)及正常冠状动脉组(C组)各30例.比较3组之间的一般资料、心肌缺血表现;并采用校正的TIMI帧数(CTFC)对冠脉血流速度进行评估.结果 A组患者平均年龄低于B组(P<0.05),性别、平均血压、心率差异无统计学意义(P>0.05).A组心肌梗死发生率、ST-T异常率低于B组(P<0.05),心绞痛表现差异无统计学意义(P>0.05).A组CTFC较C组明显增高(P<0.05),血流速度缓慢,血流到达血管远端时间延长(P<0.05).结论 单纯冠状动脉左前降支心肌桥主要发生于年轻男性中,冠脉血流缓慢,可引起心肌缺血.%Objective To analyze the impact of myocardial blood supply in patients with left anterior descending coronary artery ( LAD ) myocardial bridge. Methods Ninety patients were divided into three groups according to the coronary an-giography: simple coronary artery myocardial bridge( group A, n = 30 ), simple coronary artery stenosis( group B, n = 30 ) and normal coronary artery( group C, n =30 ). The general materials, myocardial ischemia were observed and compared, and the coronary artery blood flow velocity and blood flow were evaluated by corrected TIMI frame count ( CTFC ) method. Results The average age in group A was lower than group B( P ＜ 0.05 ), with no statistical difference in gender, mean blood pressure, heart rate, etc( P ＞0. 05 ). The ratio of myocardial infarction and abnormal ECG changes was lower than group B( P ＜ 0. 05 ), while no statistical difference in angina( P ＞0. 05 ). The CTFC in group A was significantly higher than that in group C( P ＜0. 05 ), coronary blood flow velocity was decreased and it took more time to reach the distal of the vessel( P ＜0.05 ). Conclusion The simple coronary artery myocardial bridge was prefer to involve young male, with coronary blood flow velocity decreased and caused myocardial ischemia.