目的 探讨深在型心肌桥-壁冠状动脉(MB-MCA)形态学特征与心肌桥近段冠状动脉粥样硬化的关系.方法 回顾性分析经128层螺旋CT冠状动脉血管成像证实190例单纯深在型心肌桥-壁冠状动脉患者和190例心肌桥近段冠状动脉合并粥样硬化患者的冠状动脉CTA检查原始数据,并进行图像处理,记录患者性别、年龄,统计MB-MCA形态特征,包括测量MB厚度、MCA长度和MB-MCA邻近两段血管形态变化,应用Logistic回归分析MB-MCA形态学特征与心肌桥近段冠状动脉粥样硬化病变的关系.结果 单纯深在型MB-MCA组:男/女=2.22/1(131/59),平均年龄(51.36±11.19)岁(12～83岁),MB厚度为(2.25±1.80)mm,MCA长度为(23.58±9.57)mm,MCA两端平滑者21.05％(40/190),近端成角者7.36％(14/190),远端成角者15.79％(30/190),两端成角者55.79％(106/190).心肌桥近段冠状动脉合并动脉粥样硬化组:男/女=5.55/1(161/29),平均年龄(57.19±11.29)岁(37～86岁),MB厚度为(2.19±1.67)mm,MCA长度为(21.45±8.38)mm,MCA两端平滑者26.32％(50/190),近端成角者5.79％(11/190),远端成角者21.05％(40/190),两端成角者46.84％(89/190).性别、年龄、MCA长度和邻近两端成角情况都与心肌桥近段冠状动脉粥样硬化有关(P＜0.05),而MB厚度与心肌桥近段冠状动脉粥样硬化无关(P=0.6825＞0.05).结论 MB-MCA这一复合体是心肌桥近段冠状动脉粥样硬化病变解剖学上的危险因素.%Objective To evaluate the relation between coronary atherosclerosis of the proximal segment of deep myocardial bridge-mural coronary artery (MB-MCA) and the morphological characteristics of MB-MCA. Methods 190 patients underwent 64-MDCT presented with simple deep MB-MCA and 190 patients with deep MB-MCA accompanying with proximal segment atherosclerosis were enrolled in this study. Sex and age were analyzed. The thickness of MB and length of MCA were measured. The morphological characteristics of adjacent arteries were assessed. Logistic regression was used for data analysis. Results Simple deep MB-MCA: There were 131 males and 59 females, M/F=2. 22/1, aged from 12~ 83 years, averaged (51. 36 ±11. 19) years. The thickness of MB was (2. 25 ±1.80) mm, the length of MCA was (23. 58 ±9. 57) mm. The proximal and distal segment to the MB-MCA showed smooth in 21. 05% (40/190) of arteries, and the proximal segment demonstrated tortuous appearance in 7. 36%(14/190)of arteries, while the distal segment showed tortuous appearance in 15. 79% (30/190) of arteries, both sides of the MB-MCA presented tortuous appearance in 55. 79%(106/ 190)of the arteries; Deep MB-MCA accompanying with proximal segment atherosclerosis: There were 161 males and 29 females, M/F = 5.55/1, aged from 37~86 years, averaged (57. 19±11. 29) years. The thickness of MB was (2. 19± 1. 67) mm,the length of MCA was (21. 45± 8. 38) mm. The proximal and distal segment to the MB-MCA showed smooth in 26. 32(50/190) of arteries, and the proximal segment demonstrated tortuous appearance in 5. 79%(11/190) of arteries, while the distal segment showed tortuous appearance in 21. 05%(40/190) of arteries, both sides of the MB-MCA presented tortuous appearance in 46. 84%(89/190) of the arteries. There was a significantly difference as the morphology was concerned ( P <0. 05), except the thickness of MB ( P =0. 6825>0. 05). Conclusion MBMCA should be considered an anatomic risk factor in the evaluation of coronary atherosclerosis of proximal segment to MB-MCA.
展开▼
