文章摘要

心肌桥压缩程度与冠状动脉粥样硬化狭窄程度的关系

作者: 1,2田颖, 3丁阳, 1贾恩志
1 南京医科大学第一附属医院(江苏省人民医院)心血管内科,南京 210000
2 南京市建邺区沙洲社区卫生服务中心全科,南京 210000
3 南京中医药大学第二附属医院(江苏省第二中医院)放射科,南京 210000
通讯: 贾恩志 Email: enzhijia@njmu.edu.cn
DOI: 10.3978/j.issn.2095-6959.2020.08.012

摘要

目的:基于冠状动脉造影结果,探讨心肌桥压缩程度与冠状动脉粥样硬化狭窄程度之间的相关性。方法:对行冠状动脉造影检查的病例,回顾性分析心肌桥压缩程度与冠状动脉各节段狭窄程度的关系。采用单因素分析比较组间基线资料差异,采用相关分析探讨心肌桥压缩程度与冠状动脉粥样硬化狭窄程度之间的相关性。采用Logistic回归分析探讨是否存在心肌桥、心肌桥压缩程度对冠状动脉粥样硬化的影响。结果:共纳入455例病例,其中140例发现有心肌桥。Mann-Whitney检验结果显示:有心肌桥者左前降支近段、中段、远段,以及左回旋支近段、中段粥样硬化狭窄程度显著低于无心肌桥者,差异有统计学意义(均P<0.05)。Spearman相关分析结果显示:心肌桥压缩程度与冠状动脉粥样硬化狭窄程度(左前降支近段、中段、远段,左回旋支近段、中段)呈负相关(相关系数均<1,均P<0.05)。二元单因素Logistic回归分析结果显示:心肌桥是冠状动脉粥样硬化狭窄(左前降支近段、中段、远段,左回旋支近段)的保护因素(OR值分别为0.415,0.643,0.423,0.417,均P<0.05);心肌桥压缩程度与冠状动脉粥样硬化狭窄(左前降支近段、中段、远段,左回旋支近段、中段)的保护因素(OR值分别为0.982,0.992,0.978,0.983,0.990,均P<0.05)。二元多因素Logistic回归分析结果显示:心肌桥是左前降支近段粥样硬化(OR=0.443,P<0.001)、左前降支中段粥样硬化(OR=0.656,P=0.045)、左回旋支近段粥样硬化(OR=0.431,P=0.001)的独立保护因素。结论:心肌桥是冠状动脉粥样硬化的保护性因素,对预防冠状动脉粥样硬化有积极意义。
关键词: 冠状动脉;心肌桥;粥样硬化;血管造影

Relationship between myocardial bridge compression and coronary atherosclerotic stenosis

Authors: 1,2TIAN Ying, 3DING Yang, 1JIA Enzhi
1 Department of Internal Cardiovascular Medicine, First Affiliated Hospital of Nanjing Medical University (Jiangsu Province Hospital), Nanjing 210000, China
2 Department of General Practice, Shazhou Community Health Service Center of Jianye District, Nanjing 210000, China
3 Department of Radiology, Second Affiliated Hospital of Nanjing University of Traditional Chinese Medicine (Jiangsu Second Hospital of Traditional Chinese Medicine), Nanjing 210000, China

CorrespondingAuthor: JIA Enzhi Email: enzhijia@njmu.edu.cn

DOI: 10.3978/j.issn.2095-6959.2020.08.012

Abstract

Objective: To discuss the relationship between the myocardial bridge compression degree and coronary atherosclerosis stenosis degree depending on the result of coronary angiography. Methods: Retrospective analysis was performed to indicate the correlation between the myocardial bridge compression degree and stenosis degree of each segment of the coronary artery. Single factor analysis was applied to compare the differences of baseline data between each group. The relativity between the degree of myocardial bridge compression and coronary atherosclerosis stenosis was discussed by correlation analysis. Meanwhile, regression analysis was used to investigate the existence of myocardial bridge and effects of its compression degree on coronary atherosclerosis. Results: Myocardial bridge was found in 140 among total 455 patients. The result of Mann-Whitney Test indicated that patients with myocardial bridge had lower risk of coronary atherosclerosis stenosis degree in the proximal, middle and distal segment of the left anterior descending coronary artery, along with the proximal and middle segment of the left circumflex coronary artery than those without. The discrepancies were of statistical significance (P<0.05). It was showed in Spearman correlation analysis that the myocardial bridge compression degree was inversely related (r<1, P<0.05) to the coronary atherosclerosis stenosis degree (proximal segment of left anterior descending branch, middle segment of left anterior descending branch, distal segment of left anterior descending branch, proximal segment of left circumflex branch, middle segment of left circumflex branch). Moreover, the result of binary single factor logistic demonstrated that the myocardial bridge is the protective factor (proximal segment of left anterior descending branch, middle segment of left anterior descending branch, distal segment of left anterior descending branch, proximal segment of left circumflex branch) of coronary atherosclerosis stenosis (OR<1, P<0.05). Myocardial bridge compression degree was the protective factor (proximal segment of left anterior descending branch, middle segment of left anterior descending branch, distal segment of left anterior descending branch, proximal segment of left circumflex branch, middle segment of left circumflex branch) of coronary atherosclerosis stenosis (OR<1, P<0.05). The result of binary multiple factor logistic regression analysis revealed that the myocardial bridge was the independent protective factor of atherosclerosis in proximal left anterior descending artery (OR=0.443, P<0.001), the middle segment of left anterior descending branch (OR=0.656, P=0.045) and proximal left circumflex branch (OR=0.431, P=0.001). Conclusion: Myocardial bridge is the protective factor of coronary atherosclerosis ,which is also benefit for preventing coronary atherosclerosis.
Keywords: coronary artery; myocardial bridge; atherosclerosis; angiography