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目的探讨选择性冠状动脉造影人群中冠状动脉肌桥的发生率、临床特点及治疗。方法回顾性分析总结皖北煤电集团总医院2005年1月-2008年10月接受选择性冠状动脉造影360例患者的临床资料。结果在360例行选择性冠状动脉造影人群中共发现冠状动脉肌桥12例(3.3%),主要发生在左前降支(LAD),仅1例发生在左回旋支(LCX),其中冠脉造影显示心肌收缩时冠状动脉狭窄(50～75)%患者,主要表现为胸闷、气短、心慌者,症状好转或明显缓解;而狭窄大于75%患者,主要表现为典型心绞痛症状之患者,部分好转,部分无效,其中1例药物治疗效果不明显,给予支架植入后随访时症状减轻,复查造影支架内无狭窄,1例因反复晕厥入外院外科行心肌桥松解术治疗,随访满意。结论冠状动脉心肌桥多发生于LAD,可致典型心绞痛症状,治疗上可应用β受体阻滞剂或钙离子拮抗剂,极少病例需冠状动脉内支架置入术,或外科采用心肌桥松解术。
Objective To investigate the incidence, clinical features and treatment of coronary artery myonei in selective coronary angiography. Methods The clinical data of 360 patients undergoing selective coronary angiography from January 2005 to October 2008 in General Hospital of Wanbei Coal and Electric Group were retrospectively analyzed and summarized. Results A total of 12 coronary artery musculoskeletal branches (3.3%) were found in 360 patients with selective coronary angiography, mainly in the left anterior descending (LAD) and only in the left circumflex (LCX). Among them, coronary angiography Systolic coronary artery stenosis (50 ~ 75)% of patients showed mainly chest tightness, shortness of breath, palpitation, the symptoms improved or significantly relieved; and more than 75% of patients with stenosis, the main symptoms of patients with typical angina, some improvement, Partially ineffective, of which 1 case of drug treatment effect is not obvious, the symptoms were relieved after stent implantation, review the contrast stent without stenosis, 1 case of syncope due to the surgical treatment of myocardial bridge release surgery, follow-up satisfaction. Conclusions Coronary myocardial bridge mostly occurs in LAD, which can cause typical angina pectoris. It can be used in the treatment of β-blockers or calcium antagonists. Few cases require intracoronary stenting. Solution.