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目的研究320排冠状动脉CT血管造影(CCTA)诊断的心肌桥患者的预后。方法将2008年8月至2010年12月行CCTA的患者作为研究对象,分为3组:冠状动脉完全正常组、冠状动脉存在斑块组及单纯心肌桥组进行随访。随访的终点事件为心源性死亡、非致死性AMI、需住院的不稳定型心绞痛、因心肌缺血症状或客观证据而接受血运重建治疗、其他原因的死亡。对随访的结果进行生存分析。结果最终入选的326例患者,年龄(66.6±11.8)岁,男性184例(占43.6%)。共发现心肌桥104段,其中位于左前降支(LAD)中段的占78.9%(82/104)。104段心肌桥分布在99例患者,心肌桥的检出率是30.4%(99/326),单纯心肌桥36例。生存分析发现,单纯心肌桥与冠状动脉完全正常的患者的生存曲线之间没有差异(P=0.441),而单纯心肌桥的患者的生存曲线与存在斑块的患者的生存曲线之间的差异没有统计学意义(P>0.0167),但是两者生存曲线之间有分开的趋势。结论 320排CT冠状动脉造影诊断的单纯心肌桥患者的预后良好。
Objective To study the prognosis of patients with myocardial bridge diagnosed by 320-row coronary CT angiography (CCTA). Methods From August 2008 to December 2010, patients undergoing CCTA were divided into three groups: the normal coronary artery group, the plaque group with coronary artery and the myocardial infarction group were followed up. Follow-up end-point events were cardiac death, non-fatal AMI, unstable angina requiring hospitalization, death due to other causes of myocardial ischemia or objective evidence of revascularization. Survival analysis of follow-up results. Results The final enrolled 326 patients, age (66.6 ± 11.8) years, 184 males (43.6%). A total of 104 segments of myocardial bridge were found, of which 78.9% (82/104) located in the middle part of left anterior descending artery (LAD). The distribution of 104 myocardial bridges was found in 99 patients. The detection rate of myocardial bridge was 30.4% (99/326) and that of simple myocardial bridge was 36. Survival analysis found no difference in survival curves between patients with complete myocardial infarction and normal coronary arteries (P = 0.441), whereas differences in survival curves between patients with myocardial bridge and those with plaque did not Statistical significance (P> 0.0167), but there is a trend of separation between the two survival curves. Conclusion The prognosis of patients with isolated myocardial bridge in 320-slice CT coronary angiography is good.