本文已被：浏览 392次 下载 276次
投稿时间：2024-10-26 网络发布日期：2025-07-21
投稿时间：2024-10-26 网络发布日期：2025-07-21
中文摘要: 目的 探究心肌桥参数与冠状动脉粥样硬化患者斑块分布的关系及影响斑块稳定性的因素。方法 回顾性分析2020年10月至2023年10月西部战区总医院收治的87例冠状动脉粥样硬化性心脏病（CAD）患者，所有患者均存在冠状动脉粥样硬化斑块及心肌桥。根据心肌桥位置，将患者分为观察组［心肌桥位于左前降支（LAD）中段，56例］和对照组（其余患者，31例），所有患者根据斑块稳定性分为斑块稳定组（48例）和斑块不稳定组（39例）。比较观察组和对照组患者的临床资料、冠状动脉粥样硬化斑块分布情况、斑块稳定性；探究心肌桥参数与冠状动脉粥样硬化斑块分布的关系；比较斑块稳定组和斑块不稳定组患者的临床资料；多因素logistic回归分析影响斑块稳定性的因素。结果 与LAD中段及LAD远段相比，观察组及对照组患者分布在LAD近段的斑块均明显更多（P<0.05）。心肌桥位于LAD中段为斑块位于LAD近段的危险因素（P<0.05）。与对照组相比，观察组的不稳定斑块明显更多（P<0.05）。斑块不稳定组患者的心肌桥位于LAD中段、斑块分布于LAD近段、低密度脂蛋白胆固醇（LDL-C）水平、C反应蛋白（CRP）水平、生活事件应激史、抑郁史、吸烟明显高于斑块稳定组（P<0.05）。心肌桥位于LAD中段、斑块分布于LAD近段、高LDL-C、吸烟史、抑郁史、生活事件应激史为斑块不稳定的独立危险因素（P<0.05）。结论 LAD中段心肌桥合并冠状动脉粥样硬化患者斑块多分布于LAD近段，且与斑块稳定性有密切联系。
中文关键词: 冠状动脉粥样硬化性心脏病 左前降支中段心肌桥 冠状动脉粥样硬化 斑块分布 斑块稳定性
Abstract:Objective To explore the relationship between myocardial bridge（MB）parameters and plaque distribution in patients with coronary atherosclerosis，as well as the factors influencing plaque stability. Methods A retrospective analysis was performed on 87 patients with coronary atherosclerotic heart disease（CAD）admitted to Western Theater Command General Hospital from October 2020 to October 2023. All patients had atherosclerotic plaques and MB.According to MB location，patients were divided into observation group［MB in the mid-left anterior descending coronary artery（LAD），56 cases］and control group（other patients，31 cases）. All patients were divided into plague-stable group（48 cases） and plague-unstable group （39 cases） according to plaque stability. The clinical data ，coronary atherosclerotic plaque distribution and plaque stability of observation group and control group were compared. The relationship between MB parameters and the distribution of coronary atherosclerotic plaques was explored. The clinical data of patients in the plaque-stable group and the plaque unstable group were compared. Multivariate logistic regression was used to analyze the factors affecting plaque stability.Results Compared with the mid- and distal LAD，there were significantly more plaques in the proximal LAD in observation group and control group（P<0.05）. MB in the mid-LAD was a risk factor for plaque in the proximal LAD（P<0.05）. Compared with the control group，there were more unstable plaques in the observation group（P<0.05）. MB in the mid-LAD，plaques in the proximal LAD，low density lipoprotein cholesterol（LDL-C）level，C-reactive protein（CRP）level，life event stress history，depression and smoking in plaque unstable group were significantly higher than those in plaquestable group（P<0.05）. MB in the mid- LAD，plaques in the proximal LAD，high level of LDL-C，smoking，depression and life event stress history were independent risk factors for plaque instability（P<0.05）. Conclusion The plaques inpatients with a myocardial bridge in the mid-LAD combined with coronary atherosclerosis are mainly distributed in the proximal LAD，and are closely related to plaque stability.
keywords: Coronary arteriosclerotic heart disease Middle myocardial bridge of left anterior descending branch Coronary atherosclerosis Plaque distribution Plaque stability
文章编号： 中图分类号：R543.3 文献标志码：A
基金项目:
附件
| 作者 | 单位 |
| 陈真敏 | 1. 西部战区总医院心内科, 四川 成都 610500 |
| 李燕平 | 1. 西部战区总医院心内科, 四川 成都 610500 |
| 何慧琼 | 2. 西部战区总医院干部一科三病区, 四川 成都 610500 |
| 吴希 | 2. 西部战区总医院干部一科三病区, 四川 成都 610500 |
| Author Name | Affiliation |
| CHEN Zhenmin*，Li Yanping，HE Huiqiong，WU Xi | *Department of Cardiology,Western Theater Command General Hospital,Chengdu,Sichuan 610500,China |
引用文本：
陈真敏,李燕平,何慧琼,等.左前降支中段心肌桥参数与冠状动脉粥样硬化斑块分布特征及斑块稳定性影响因素[J].中国临床研究,2025,38(7):1056-1060.
陈真敏,李燕平,何慧琼,等.左前降支中段心肌桥参数与冠状动脉粥样硬化斑块分布特征及斑块稳定性影响因素[J].中国临床研究,2025,38(7):1056-1060.