本文選題：心肌橋 + 左前降支冠狀動脈��； 參考：《寧夏醫(yī)科大學(xué)》2017年碩士論文

【摘要】：目的應(yīng)用血管內(nèi)超聲探討前降支心肌橋與冠狀動脈粥樣硬化之間的相關(guān)性。方法選取2013年6月至2016年12月期間就診寧夏醫(yī)科大學(xué)附屬總醫(yī)院和心腦血管醫(yī)院心內(nèi)科,并在導(dǎo)管室內(nèi)行血管造影同時行血管內(nèi)超聲的患者共102例。前降支心肌橋合并冠狀動脈粥樣硬化患者50例為A組,前降支冠狀動脈粥樣硬化不合并心肌橋的患者52例為B組,進(jìn)一步再將A組根據(jù)病變程度分為A1、A2和A3組,分別對比A組和B組以及A1、A2和A3組冠脈粥樣硬化危險因素的差異。收集的所有數(shù)據(jù)均采用SPSS17.0統(tǒng)計軟件包統(tǒng)一處理,計數(shù)資料用百分率表示,計量資料使用均數(shù)±標(biāo)準(zhǔn)差表示,所有結(jié)果檢驗(yàn)標(biāo)準(zhǔn)為P0.05具有統(tǒng)計學(xué)意義。結(jié)果1、A組和B組結(jié)果比較:AB組兩組在血脂異常上差異具有統(tǒng)計學(xué)意義(A組VS B組,48.00%VS 67.31%,P0.05),而且A組的總膽固醇、甘油三酯、低密度脂蛋白水平均低于B組(A組VS B組,3.78±1.17mmol/L VS 4.30±1.44mmol/L;1.88±1.17mmol/L VS 2.51±1.62mmol/L;2.31±1.02mmol/L VS 2.93±1.36mmol/L,P0.05),兩組間差異具有統(tǒng)計學(xué)意義。而其他所測得的危險因素兩組間差異在統(tǒng)計學(xué)上無意義(P0.05)。2、A1組、A2組、A3組之間結(jié)果比較:三組之間的心肌橋厚度水平A1組(0.39±0.14)、A2組(0.42±0.18)、A3組(0.58±0.22)和AC水平A1組(21.05±9.86)、A2組(23.14±9.3)、A3組(30.74±10.89)均呈逐漸遞增的趨勢,采用非參數(shù)檢驗(yàn),三組間差異不完全相等,具有統(tǒng)計學(xué)意義(P0.05)。對Max PB分別做和心肌橋厚度、AC相關(guān)性分析,P0.05,均呈顯著性正相關(guān)。而其他所測得的危險因素三組間差異在統(tǒng)計學(xué)上無意義(P0.05)。3、另外,50例前降支心肌橋患者,經(jīng)統(tǒng)計發(fā)現(xiàn)合并有粥樣硬化斑塊處共77處,MB近段血管50處(64.94%),肌橋部血管14處(18.18%),MB遠(yuǎn)段血管13處(16.88%),通過非參數(shù)檢驗(yàn)分析可知,差異顯著,具有統(tǒng)計學(xué)意義(P0.05)。結(jié)論1.心肌橋患者與無心肌橋患者相比,兩者在形成相當(dāng)量的斑塊時,心肌橋患者可能需要較低濃度的血脂即可,即敏感性可能更高。2.前降支存在心肌橋的患者容易在心肌橋近段形成冠狀動脈硬化斑塊。3.心肌橋的厚度和肌橋?qū)Ρ诠跔顒用}的壓縮程度與冠狀動脈狹窄程度呈正相關(guān),提示心肌橋可能對冠狀動脈粥樣硬化的過程起著重要的影響作用。
[Abstract]:Objective to investigate the relationship between anterior descending myocardial bridge and coronary atherosclerosis by intravascular ultrasound. Methods from June 2013 to December 2016, 102 patients were admitted to the General Hospital of Ningxia Medical University and the Cardiovascular and Cerebrovascular Hospital. 50 patients with anterior descending coronary artery with coronary atherosclerosis and 52 patients with anterior descending coronary artery atherosclerosis without myocardial bridge were divided into two groups according to the degree of lesion. The risk factors of coronary atherosclerosis were compared between group A and group B, as well as group A 1 A 2 and group A 3. All the collected data were processed by SPSS17.0 statistical software package, the counting data were expressed by percentage, the measurement data were expressed by mean 鹵standard deviation, and all the results were tested by P05 with statistical significance. Results 1Compared with group B, there were significant differences in blood lipid abnormalities between group A and group B. there were significant differences between group A and group A (vs group B, P 0.05, vs 67.31), and the total cholesterol and triglyceride in group A, and serum triglyceride (TG), total cholesterol (TC), triglyceride (TG), triglyceride (TG) in group A (P < 0.05). The level of low density lipoprotein in group A was lower than that in group B (3.78 鹵1.17mmol/L vs 4.30 鹵1.44 mmol / L, 1.88 鹵1.17mmol/L vs 2.51 鹵1.62 mmol / L, 2.31 鹵1.36 mmol / L vs 2.93 鹵1.36 mmol / L, P 0.05), and there was significant difference between the two groups. The difference of other risk factors between the two groups was not statistically significant. The results showed that the myocardial bridge thickness of group A 1 (0.39 鹵0.14) was 0.42 鹵0.18 (0.58 鹵0.22) and that of AC A 1 was 21.05 鹵9.86 (30.74 鹵10.89), and that of A _ 2 and A _ (3) was increased gradually (P _ (0.05). 2A _ (2) A _ (2) and A _ (2) (0.39 鹵0.14 鹵0.14) A _ (3) and AC _ (A _ 1) (P _ (0.05) 鹵(9.86) A _ (2) (30.74 鹵10.89), respectively. Using non-parametric test, the difference between the three groups was not completely equal, with statistical significance (P 0. 05). The correlation between Max PB and myocardial bridge thickness (AC) was significant positive correlation (P 0.05). There was no statistically significant difference in other risk factors among the three groups. In addition, there were 50 patients with anterior descending myocardial bridge. It was found that there were 77 proximal vessels with atherosclerotic plaques in 50 vessels at 64.94 and 14 vessels in muscle bridge at 18.1818MB in 13 and 16.88 in the distal segment. The results of non-parametric analysis showed that the difference was significant, and the difference was statistically significant (P 0.05). Conclusion 1. Myocardial bridge patients may need lower serum lipids when they form a significant number of plaques compared with those without myocardial bridge patients, that is, the sensitivity may be higher. 2. Patients with anterior descending branch of myocardial bridge are prone to develop coronary atherosclerotic plaque. 3. 3 in the proximal segment of the myocardial bridge. The thickness of myocardial bridge and the degree of compression of myocardial bridge to mural coronary artery were positively correlated with the degree of coronary artery stenosis, suggesting that myocardial bridge may play an important role in the process of coronary atherosclerosis.
【學(xué)位授予單位】：寧夏醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R541

【參考文獻(xiàn)】

相關(guān)期刊論文 前10條

1 李紅堯;龔波;吳惠明;高永炳;陸成棟;;冠狀動脈心肌橋相關(guān)粥樣斑塊的CT研究[J];中國醫(yī)學(xué)創(chuàng)新;2016年29期

2 付大偉;伍崇海;鐘峗;熊龍根;徐麗敏;王靜;徐如芹;何詠聰;劉世明;;心肌橋與無心肌橋者在冠狀動脈粥樣硬化過程中危險因素的差異[J];臨床心血管病雜志;2015年02期

3 張剛;桂鳴;唐立鈞;楊志健;曹克將;;冠狀動脈前降支心肌橋近端粥樣硬化狹窄的危險因素[J];中華高血壓雜志;2012年10期

4 王峻奇;馬趙;仝莉;;心肌橋的雙源CT冠狀動脈血管成像診斷及臨床意義[J];臨床放射學(xué)雜志;2012年08期

5 劉力生;;中國高血壓防治指南2010[J];中華高血壓雜志;2011年08期

6 賈永紅;楊濱;唐萍萍;;心肌橋的螺旋CT血管造影成像特點(diǎn)及其與冠狀動脈粥樣硬化關(guān)系[J];CT理論與應(yīng)用研究;2010年02期

7 李文華;劉曉麗;蔡平;;心肌橋壁冠狀動脈內(nèi)皮細(xì)胞超微結(jié)構(gòu)及血流動力學(xué)變化[J];中國組織工程研究與臨床康復(fù);2010年20期

8 張萍;黨群;李永健;張虹;;心肌橋與心血管危險因素和冠狀動脈粥樣硬化的關(guān)系研究[J];實(shí)用心腦肺血管病雜志;2010年02期

9 楊栓鎖;湯磊;陳暉;仇興標(biāo);方唯一;;心肌橋Noble分級和發(fā)生位置與冠狀動脈粥樣硬化的關(guān)系[J];上海交通大學(xué)學(xué)報(醫(yī)學(xué)版);2009年08期

10 江森;林順發(fā);毛定飚;滑炎卿;;心肌橋與橋前段粥樣硬化關(guān)系的多層螺旋CT研究[J];上海醫(yī)學(xué)影像;2008年04期

，

本文編號：1898202