心肌桥患者临床症状与壁冠状动脉类型相互关系的研究

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目的研究心肌桥患者临床症状出现率与壁冠状动脉类型之间的相互关系。方法搜集经临床确诊的185例单纯性心肌桥患者(无冠状动脉粥样硬化及心、肺、纵隔或胸膜病变)的双源CT冠状动脉成像及临床资料,比较有、无症状者两组间壁冠状动脉长度、深度及狭窄程度的差别,比较完全性肌桥和不完全性肌桥患者的症状出现率的差别。采用t检验比较有、无症状组间壁冠状动脉的长度、深度及狭窄程度的差别,采用卡方检验比较不同类型肌桥患者症状出现率间的差别。结果有症状者92例,无症状者93例;不完全性肌桥118例,完全性肌桥67例。症状组与无症状组壁冠状动脉长度分别为(2.19±1.11)cm、(1.93±0.90)cm,两者间差异无统计学意义(t=1.709,P=0.089),两组壁冠状动脉深度分别为(0.20±0.08)cm、(0.24±0.19)cm,两者间差异无统计学意义(t=-1.048,P=0.298),两组壁冠状动脉的狭窄率分别为(23.8±15.5)%、(13.1±11.0)%,两者间差异有显著的统计学意义(t=5.447,P=0.000);完全性肌桥和不完全性肌桥患者的症状出现率分别为61.2%(41/67)和43.2%(51/118),两者间差异有统计学意义(χ2=5.522,P=0.019);壁冠状动脉在收缩期及舒张期均有狭窄时症状出现率最高。结论完全性肌桥患者及舒张期壁冠状动脉狭窄患者更易出现临床症状,应予以高度重视。 Objective To study the relationship between the incidence of clinical symptoms and the type of wall coronary artery in patients with myocardial bridge. Methods The double-source CT coronary angiography and clinical data of 185 patients with simple myocardial bridge (no coronary atherosclerosis and heart, lung, mediastinum or pleural disease) clinically diagnosed were collected and compared. There was no significant difference between the two groups Coronary artery length, depth and stenosis of the difference between the comparison of complete muscle bridge and incomplete muscle bridge in patients with symptoms of the difference. The differences of the length, depth and stenosis between the asymptomatic group and the control group were compared by t-test. The differences between the symptoms of different types of muscle bridges were compared by chi-square test. Results 92 cases of symptomatic, 93 cases of asymptomatic; 118 cases of incomplete muscle bridge, 67 cases of complete muscle bridge. There was no significant difference between the two groups (t = 1.709, P = 0.089). The length of the coronary artery in the two groups was (2.19 ± 1.11) cm and (1.93 ± 0.90) cm (0.20 ± 0.08) cm and (0.24 ± 0.19) cm respectively. There was no significant difference between the two groups (t = -1.048, P = 0.298). The stenosis rates of the coronary artery in the two groups were (23.8 ± 15.5) %, (13.1 ± 11.0)% respectively. The difference between the two groups was statistically significant (t = 5.447, P = 0.000). The incidence of symptoms in patients with complete muscle bridge and incomplete muscle bridge were 61.2% / 67) and 43.2% (51/118), respectively. There was a significant difference between the two groups (χ2 = 5.522, P = 0.019). The incidence of symptoms was the highest in all patients with stenosed coronary arteries. Conclusion Patients with complete muscle bridge and patients with diastolic wall coronary artery stenosis are more likely to have clinical symptoms and should be given high priority.
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