摘要
目的分析心率变化对冠状动脉肌桥患者的冠脉收缩期压缩程度的影响。方法选取2017年6月至2019年2月在济宁市第一人民医院心内科行冠状动脉造影示中重度冠脉肌桥(收缩期压缩50%以上)的患者共32例,男19例,女13例,Noble II级23例,NobleⅢ级9例,静脉注射艾司洛尔(超短效的选择性β1-受体阻滞剂),使心率下降10%~20%,观察血压变化,重复冠状动脉造影,记录收缩期肌桥下冠状动脉压缩程度。结果冠状动脉肌桥均位于前降支,以前降支中段为主,占71.88%,冠状动脉肌桥平均长度为(20.62±5.13)mm,冠状动脉肌桥长度与收缩期冠状动脉肌桥压缩程度无相关关系(P=0.633),静脉注射艾司洛尔使心率下降10%~20%后,血压变化无统计学差异(收缩压P=0.203,舒张压P=0.092),收缩期冠状动脉肌桥压缩程度均减轻,肌桥分级由Noble II级23例变为NobleⅠ级21例,NobleⅢ级9例变为NobleⅠ级8例,NobleⅡ级1例,我们发现心率与收缩期冠状动脉肌桥压缩程度无明显相关关系(P=0.516),但静脉注射艾司洛尔使心率下降10%-20%时,发现心率下降程度与收缩期冠状动脉肌桥压缩减少程度成正相关(r=0.526,P=0.002)。结论艾司洛尔对冠状动脉肌桥压缩50%以上患者有效,心率下降10%~20%后,收缩期肌桥下冠状动脉压缩程度减少,且减少程度与心率下降程度成正相关。
Objective To analyze the effect of heart rate variation on the degree of systolic compression in patients with myocardial bridge.Methods 32 patients(19 males,13 females)with medium and severe myocardial bridge(systolic compression over 50%)were selected,who were diagnosed with coronary angiography in the department of cardiology in Jining First People’s Hospital from June 2017 to February 2019,including 23 cases of myocardial bridge Nobel level II,9 cases of level III.All patients were injected with esmolol during coronary angiography in order to reduce their heart rate by 10%-20%,therewith their blood pressure and systolic compression degree were observed and recorded.Results The myocardial bridges were located in the anterior descending branch,which were mainly in the middle segment of the anterior descending branch(71.88%).The average length of the myocardial bridges was 20.62±5.13 mm.There was no correlation between the length of the myocardial bridge and the systolic compression degree(P=0.633).After the administration of esmolol,there was no significant difference in blood pressure changes(systolic blood pressure p=0.203,diastolic blood pressure P=0.092),while the systolic compression degree of myocardial bridge was significantly alleviated,for example,in all Noble level II cases(23),21 cases alleviated to level I,meanwhile in all Noble level III cases(9),8 cases alleviated to level I,1 case turned to level II.There was no significant correlation between the heart rate and the systolic compression degree(P=0.516).However,when the heart rate was reduced by 10%-20%,it was found that the degree of decrease in heart rate was positively correlated with the degree of reduction of myocardial bridge compression in systolic period(r=0.526,P=0.002).Conclusions Esmolol is effective in patients with medium and severe myocardial bridge,when heart rate was reduced by 10%-20%,the systolic compression degree of myocardial bridges is accordingly alleviated,and the degree of decrease in heart rate is positively correlated with the degree of reduction of myocardial bridge compression in systolic period.
作者
欧福伟
衣少伟
霍倩倩
曹先存
武宗寅
OU Fu-wei;YI Shao-wei;HUO Qian-qian;Cao Xian-cun;WU Zong-yin(Department of Cardiology,Medicine and Life Sciences College,University of Jinan,Shandong Academy of Medical Sciences,Jinan 250062;Department of Cardiology,Jining First People's Hospital,Shandong Academy of Medical Sciences,Jining 272000,Shandong;The People's Hospital of Yanzhou District,Yanzhou 272100,Shandong,China)
出处
《中国分子心脏病学杂志》
CAS
2019年第5期3073-3075,共3页
Molecular Cardiology of China
作者简介
通信作者:武宗寅,Email:wuzysp@163.com。
