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心肌桥近端并发冠心病的患者临床及影像学特点
引用本文:张剑,荆全民,王效增,马颖艳,王耿,刘海伟,韩雅玲.心肌桥近端并发冠心病的患者临床及影像学特点[J].心脏杂志,2015,27(2):190-193.
作者姓名:张剑  荆全民  王效增  马颖艳  王耿  刘海伟  韩雅玲
作者单位:沈阳军区总医院全军心血管病研究所心内科,辽宁沈阳,110840
摘    要:目的:回顾性分析心肌桥(MB)近端并发严重狭窄的冠心病患者临床和冠状动脉造影的影像学资料,与单纯MB患者作对照比较,探讨MB并发冠心病患者的临床易患因素和影像学特点。方法:病例组选择MB近端冠状动脉粥样硬化并发狭窄(≥70%)患者92例,均为冠脉血管前降支(LAD)病变,对照组选择同期入院有临床症状的单纯前降支MB患者100例,比较两组之间的临床特征和影像学特点。结果:两组患者临床特征比较,病例组与对照组年龄(58±11)岁vs.(52±10)岁]、收缩压(158±10)mm Hg vs.(146±10)mm Hg)]和高脂血症比例(36%vs.15%)均显著高于对照组,差异均有统计学意义。实验室及辅助检查显示病例组与对照组血浆总胆固醇水平(5.9±1.8)mmol/L vs.(4.7±1.2)mmol/L]、低密度脂蛋白胆固醇水平(4.3±1.4)mmol/L vs.(3.0±1.1)mmol/L]均有显著差异。冠状动脉注入硝酸甘油后病例组MB收缩期压缩程度(74±10)%vs.(67±9)%]高于对照组,而两组间平均MB血管长度(27±12)mm vs.(26±10)mm]、MB血管直径(3.1±1.1)mm vs.(3.2±0.9)mm]和MB近端距离前降支口部距离(51±10)mm vs.(48±11)mm]没有显著差异。结论:MB近端并发严重冠状动脉粥样硬化病变的患者具有更多的冠心病易患因素。

关 键 词:心肌桥    冠状动脉粥样硬化    冠状动脉造影
收稿时间:2014-05-22

Clinical and angiographic features of patients with atherosclerosis in seg-ments proximal to myocardial bridge
ZHANG Jian;JING Quan-min;WANG Xiao-zeng;MA Ying-yan;WANG Geng;LIU Hai-wei;HAN Ya-ling.Clinical and angiographic features of patients with atherosclerosis in seg-ments proximal to myocardial bridge[J].Chinese Heart Journal,2015,27(2):190-193.
Authors:ZHANG Jian;JING Quan-min;WANG Xiao-zeng;MA Ying-yan;WANG Geng;LIU Hai-wei;HAN Ya-ling
Affiliation:Department of Cardiology,Shenyang General Hospital & PLA Cardiovascular Research Institute,Shenyang Military Area Command
Abstract:AIM: To retrospectively analyze the clinical and imaging features of myocardial bridge combined with severe atherosclerotic lesions in the segments proximal to the myocardial bridge and to compare the features with those of only myocardial bridge. METHODS: The study population( 192 patients)consisted of two groups: CHD group of 92 patients with severe atherosclerosis lesion of luminal narrowing of ≥70% in the segments proximal to the myocardial bridge and the bridge group of 100 patients with symptomatic myocardial bridge lesion of systolic luminal narrowness. The clinical and imaging features of the two groups were compared. RESULTS: Mean age ( 58 ± 11) years vs.( 52 ± 10) year,systolic pressure( 157. 8 ± 9. 8) mm Hg vs.( 146. 1 ± 10. 2) mm Hg]and ratios of hyperlipidemia( 36 vs. 15%)in the CHD patients were higher than those in the bridge group. The mean levels of Chol ( 5. 9 ± 1. 8)mmol / L vs.( 4. 7 ± 1. 2) mmol / L] and LDL ( 4. 3 ± 1. 4) mmol / L vs.( 3. 0 ± 1. 1) mmol / L] in the CHD group were also higher than those in the bridge group( P < 0. 05). There was a significant difference in the extent of diameter stenosis during systolic stage between groups ( 74 ± 10) % vs.( 67 ± 9) %].CONCLUSION: Patients with severe atherosclerosis lesion in the segments proximal to the myocardial bridge have more CHD risk factors and the extent of diameter stenosis during systolic stage has some promoting effect on CHD development.
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