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目的:探讨心肌桥的冠状动脉造影特点与心电图、运动试验之间的关系。方法:回顾性分析经冠状动脉造影证实的98例单纯性心肌桥的冠状动脉造影和心电图的特点。结果:冠状动脉造影单纯性心肌桥均位于左前降支,且大部分位于中远端,按Nobel分级,I级58例(59.1%),Ⅱ级27例(27.6%),Ⅲ级13例(13.3%)。心肌桥深度:浅表型70例(68.6%),深在型28例(31.4%),深在型缺血性ST段和T波改变的发生明显高于浅表型。心肌桥患者静息心电图主要表现为V3-V6导联ST段压低,T波低平或倒置;部分病例呈早期复极样改变。36例行运动试验,阳性18例(50%),可疑阳性11例(31.6%)。结论:冠状动脉心肌桥可能导致ST段、T波改变,部分患者运动试验阳性或可疑阳性心肌缺血,但是有多种方案治疗的。
Objective: To investigate the relationship between coronary angiography and electrocardiogram (ECG) and exercise test in myocardial bridge. Methods: The characteristics of coronary angiography and electrocardiogram in 98 patients with simple myocardial bridge confirmed by coronary angiography were analyzed retrospectively. Results: Myocardial bridge of coronary angiography was located in the left anterior descending branch, most of which located in the middle and distal end. According to Nobel classification, 58 cases were grade I (59.1%), 27 cases were grade Ⅱ (27.6%), 13 cases were grade Ⅲ 13.3%). The depth of myocardial bridge was 70 cases (68.6%) in superficial type and 28 (31.4%) in deep type. The changes of ischemic ST segment and T wave in deep type were significantly higher than those in superficial type. Resting electrocardiogram in patients with myocardial bridge mainly for the ST segment depression of V3-V6 lead, T wave low flat or inverted; some cases showed early repolarization changes. 36 routine exercise test, positive in 18 cases (50%), suspicious positive in 11 cases (31.6%). CONCLUSIONS: Coronary myocardial bridge may result in changes of ST segment and T wave. Some patients have positive or suspicious positive myocardial ischemia, but there are many schemes for treatment.