70例心肌桥患者的心电图特征与冠状动脉造影特点相关性分析-现代医学

70例心肌桥患者的心电图特征与冠状动脉造影特点相关性分析

单位：南京医科大学第二附属医院心内科, 江苏南京 210011

分类号：R543.3

出版年·卷·期（页码）：2018·46·第十一期（1247-1252）

摘要：

目的：探讨心肌桥的冠状动脉造影特点及其与静息12导联心电图特征的相关性。方法：回顾性分析经冠状动脉造影确诊的单纯性心肌桥患者的造影结果及心电图特征。结果：2016年6月至2018年6月在本院行冠状动脉造影的患者共640例，诊断为心肌桥的患者有101例，排除固定狭窄与心肌桥合并固定狭窄的患者后单纯心肌桥患者为70例。其中男女各35例；男性年龄（56.86±10.87）岁，女性年龄（61.71±7.48）岁，差异有统计学意义（t=2.178，P=0.033）。Nobel分级Ⅰ级、Ⅱ级和Ⅲ级患者的心电图ST异常率分别为2.9%、5.7%和7.1%，差异有统计学意义（χ²=10.104，P=0.001）；窦性心动过缓与优势型左、右和均衡型的异常发生率分别为5.7%、10.0%和5.7%，差异有统计学意义（χ²=8.123，P=0.017）；15例有束支阻滞，其中3例完全右束支阻滞合并左前分支传导阻滞，12例不完全性右束支阻滞或左前分支阻滞，14例在前降支中段，1例在前降支远段，束支阻滞在冠脉造影Nobel分级、优势型和狭窄远近方面差异无统计学意义。结论：心肌桥患者多无心电图ST段改变，仅在狭窄严重时伴有ST段异常。心肌桥患者有较高窦性心动过缓和束支传导阻滞的发生率。

Objective:To explore the correlation between coronary angiography and resting 12-lead ECG characteristics in myocardial bridge. Methods:70 patients of simple myocardial bridge were retrospectively analyzed in coronary angiography and electrocardiographic feature. Results:Among 640 patients receiving coronary angiography from June 2016 to June 2018 in our hospital, 101 patients were diagnosed of myocardial bridge. After excluding fixed stenosis combined with myocardial bridge, 70 simple patients with myocardial bridge were taken as research objects. 35 men and women were aged (59.25±9.58) and (61.71±7.48) years old respectively. There were significant differences in ages (t=2.178,P=0.033). There were very significant differences in ECG ST change incidences of different Nobel classifications (χ²=10.104,P=0.005). The incidences of ECG ST change were 2.9%, 5.7% and 7.1% respectively in Nobel Ⅰ, Ⅱ and Ⅲ. There were significant differences in sinus bradycardia incidences among different coronary dominant patterns (χ²=8.123, P=0.017). The incidences of sinus bradycardia were 5.7%, 10.0% and 5.7% respectively.Among 15 cases found with bundle branch block, there were 3 cases with complete right bundle branch block combining left anterior branch block and 12 cases with incomplete right bundle branch block or left anterior branch block; 14 cases were at the middle of left anterior descending artery and 1 case at far of left anterior descending artery. Conclusion:There is no change on ECG ST segment in patients with myocardial bridge, but abnormalityis only seen in serious stenosis of coronary artery. Patients with myocardial bridge have higher incidence of sinus bradycardia and bundle branch block.

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