中国医学科学院学报

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中国医学科学院学报

中国医学科学院学报 ›› 2020, Vol. 42 ›› Issue (6): 766-770.doi: 10.3881/j.issn.1000-503X.12235

• 论著 • 上一篇    下一篇

心肌桥患者冠状动脉迂曲与狭窄的相关性

蔡东旭,施进喜,赵新斌(),齐志   

  1. 华北理工大学附属医院CT室,河北唐山 063000
  • 收稿日期:2019-11-11 出版日期:2020-12-30 发布日期:2021-01-11
  • 通讯作者: 赵新斌 E-mail:zhaoxinbinchenlei@163.com

Correlation between Coronary Artery Tortuosity and Stenosis in Patients with Myocardial Bridge

CAI Dongxu,SHI Jinxi,ZHAO Xinbin(),QI Zhi   

  1. Department of CT,the Affiliated Hospital of North China University of Science and Technology,Tangshan,Hebei 063000,China
  • Received:2019-11-11 Online:2020-12-30 Published:2021-01-11
  • Contact: ZHAO Xinbin E-mail:zhaoxinbinchenlei@163.com

摘要:

目的 分析前降支心肌桥患者冠状动脉迂曲与狭窄程度的相关性。方法 回顾性分析2015年10月至2018年12月于华北理工大学附属医院CT冠状动脉成像检查发现前降支心肌桥患者,从中选取前降支无迂曲者及迂曲者各278例,记录入选者的临床资料(年龄、性别、高血压、高血脂、糖尿病、吸烟史及家族史)、前降支狭窄发生率及狭窄程度情况。比较前降支心肌桥患者冠状动脉无迂曲组与迂曲组的临床资料、狭窄发生率及狭窄程度的差异;比较冠状动脉无、轻、中、重度迂曲组的临床资料、狭窄发生率及狭窄程度的差异。结果 冠状动脉无迂曲组的狭窄发生率(57.6%)低于迂曲组(71.9%),差异有统计学意义($\bar{χ}$=12.608,P<0.001);冠状动脉轻度迂曲组狭窄发生率(78.5%)高于无迂曲组(57.6%),差异有统计学意义($\bar{χ}$=20.462,P<0.001);冠状动脉轻度迂曲组狭窄发生率(78.5%)高于中度迂曲组(61.5%),差异有统计学意义($\bar{χ}$=7.872,P=0.005);冠状动脉迂曲组狭窄程度与无迂曲组差异有统计学意义,且迂曲组比无迂曲组更易出现较重的狭窄(Z=-3.292,P=0.001)。冠状动脉无、轻、中、重度迂曲组的狭窄程度有差异,差异具有统计学意义(H=17.787,P<0.001),且差异具有等级相关性(rs=0.169,P=0.000);冠状动脉无迂曲组狭窄发生率与中、重度迂曲组差异均无统计学意义(P均>0.05);冠状动脉轻、中度迂曲组狭窄发生率与重度迂曲组差异均无统计学意义(P均>0.05)。结论 心肌桥患者冠状动脉迂曲者比无迂曲者更易出现冠状动脉狭窄,轻度迂曲者狭窄发生率高于无、中度迂曲者;而轻度迂曲者更易出现较重程度的狭窄,无迂曲者狭窄程度常较轻。

关键词: 心肌桥, 冠状动脉迂曲, 冠状动脉狭窄程度, CT冠状动脉造影

Abstract:

Objective To analyze the correlation between tortuosity and stenosis in patients with myocardial bridge(MB)on the left anterior descending artery(LAD). Methods Data of patients with MB on the LAD,which was discovered by coronary computed tomography angiography(CCTA),in the Affiliated Hospital of North China University of Science and Technology from October 2015 to December 2018 were retrospectively analyzed.Among them 278 patients with tortuosity on LAD and 278 patients without tortuosity were selected.The clinical charateristics(age,gender,hypertension,hyperlipidemia,diabetes,smoking history,and family history)as well as the incidence and severity of stenosis of LAD were recorded and compared. Results The incidence of coronary artery stenosis in the non-tortuosity group(57.6%)was significantly lower than that in the tortuosity group(71.9%)($\bar{χ}$=12.608,P<0.001).It was also significantly higher in mild tortuosity group(78.5%)than in non-tortuosity group(57.6%)($\bar{χ}$=20.462,P<0.001)and moderate tortuosity group(61.5%)($\bar{χ}$=7.872,P=0.005).The degree of coronary artery stenosis was significantly different between tortuosity group and non-tortuosity group,and the tortuosity group was more likely to have more severe stenosis than the non-tortuosity group(Z=-3.292,P=0.001).The stenosis degree of the patients with no,mild,moderate and severe tortuosity was significantly different(H=17.787,P<0.001),and the differences had a rank correlation(rs=0.169,P=0.000).However,the incidence of stenosis was not significantly different among the none,moderate,and severe tortuosity groups(all P>0.05).There was no significant difference among the incidence of stenosis among the mild,moderate,and severe coronary artery tortuosity group(all P>0.05). Conclusions Patients with coronary artery tortuosity are more likely to have coronary artery stenosis than those without tortuosity.The stenosis rate in patients with mild tortuosity is higher than in patients without tornuosity or with moderate tortuosity.Patients with mild tortuosity are more likely to experience more severe stenosis,while those without tortuosity are more likely to have milder stenosis.

Key words: myocardial bridge, coronary artery tortuosity, degree of coronary artery stenosis, computed tomography coronary angiography

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