【摘要】 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。更多还原

【Abstract】 Objective To investigate the prognosis of patients with myocardial bridges diagnosed by320-row coronary computed tomography angiography( CCTA). Methods Patients undergoing 320-row CCTA between August 2008 and December 2010 were enrolled and divided into normal coronary artery,coronary arterial plaque and myocardial bridge groups. All patients were followed up for the endpoint events including cardiac death,non-fatal acute myocardial infarction( AMI),unstable angina requiring hospitalization,and receiving revascularization treatment due to myocardial ischemic symptoms and objective evidence and death from other causes. The follow-up outcomes were subject to survival analysis. Results Eventually,326 patients,184( 43. 6%) male,were eligible for subsequent follow-up,aged( 66. 6 ± 11. 8) years on average. In total,104 segments with myocardial bridges were identified,78. 9%( 82 /104) occurring in the middle segment of the left anterior descending( LAD) artery. The myocardial bridges were distributed in 99 patients with a detection rate of 30. 4%( 99 /326). Thirty six patients had simple myocardial bridges. Survival analysis showed that the survival curves did not significantly differ between patients with simple myocardial bridges and those with normal coronary artery( P = 0. 441). The survival curve of patients with simple myocardial bridging did not significantly differ from that of their counterparts with coronary arterial plaque( P > 0. 0167),whereas a divergent trend was noted between two groups. Conclusion Patients with simple myocardial bridges diagnosed by 320-row CCTA have good clinical prognosis.更多还原