CT冠状动脉成像评估心肌桥与冠状动脉粥样硬化的关系-现代医学

CT冠状动脉成像评估心肌桥与冠状动脉粥样硬化的关系

单位：1. 上海健康医学院附属周浦医院心血管内科, 上海 201318;
2. 上海健康医学院附属周浦医院消化内科, 上海 201318;
3. 上海健康医学院附属周浦医院放射科, 上海 201318

分类号：R541.4

出版年·卷·期（页码）：2019·47·第四期（385-388）

摘要：

目的：利用CT冠状动脉（简称冠脉）成像探究心肌桥（MB）与冠脉粥样硬化（AS）的关系。方法：选择我院经CT冠脉成像诊断发现MB的患者为研究对象，根据是否伴有冠脉AS分为MB合并冠脉AS组和单纯MB组，利用单、多因素分析患者MB的解剖特征；进一步利用受试者工作特征曲线（ROC曲线）分析潜在指标评估MB合并冠脉AS的诊断效能及最佳诊断点。结果：MB厚度及壁冠脉（MCA）收缩期压迫程度、舒张期压迫程度、收缩期狭窄率对MB合并冠脉AS的发生存在显著影响（均P<0.05）。其诊断冠脉AS的ROC曲线下面积分别为0.858、0.776、0.735和0.722。MB厚度诊断冠脉AS的最佳诊断点为2.3 mm，MCA收缩期压迫程度为36.3%。当MB厚度>2.3 mm时，患者合并冠脉AS的风险是MB厚度≤ 2.3 mm的8.953倍；当MCA收缩期压迫程度>36.3%时，患冠脉AS的危险性是≤ 36.3%的4.475倍。结论：MB厚度和收缩期压迫程度对MB合并冠脉AS的影响最大。

Objective:To evaluate the relationship between myocardial bridge(MB) and coronary atherosclerosis(AS) by CT coronary angiography. Methods:Patients with MB diagnosed by CT coronary angiography in our hospital were used as the study subjects. According to whether combined with coronary AS, they were divided into MB combined with coronary AS group and simple MB group. The MB anatomic features were analyzed by single and multivariate factors analysis. The ROC curve was used to analyze the potential indicators to evaluate the diagnostic efficiency and the best diagnostic cutoff points of MB combined with coronary AS. Results:MB thickness, systolic compression, diastolic compression and MCA systolic stenosis had a significant effect on the occurrence of MB combined with coronary AS, and the differences were statistically significant(all P<0.05). The area under the ROC curve for the diagnosis of coronary AS was 0.858, 0.776, 0.735 and 0.722, respectively. The best diagnostic cutoff point for coronary AS in MB thickness was 2.3 mm and systolic compression was 36.3%. When the MB thickness was >2.3 mm, the risk of patients with coronary AS was 8.953 times than that of MB thickness ≤ 2.3 mm. When the systolic compression of MB was >36.3%, the risk of patients suffering from coronary AS was 4.475 times than that ≤ 36.3%. Conclusion:MB thickness and systolic compression have the greatest impact on MB combined with coronary AS.

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