摘要
目的 报道 2 例以急性心肌缺血为突出表现的儿童冠状动脉心肌桥并文献复习总结.方法 介绍本院收治的 2 例儿童冠状动脉心肌桥病例,检索 1990 年～2021 年的关于儿童冠状动脉心肌桥等研究文献,获取相关数据.对纳入的研究数据采用SPSS 25.0 及RevMan 5.0软件进行统计学分析.结果 共纳入27篇文献,包括98例患儿,其中男61例,女37例,男女比例1.6∶1,发病年龄(12.2±4.9)岁.最常见的症状是胸痛 42 例(48%).98 例患儿中包括 108 段心肌桥,位置在左前降支 98 段,占比 90.7%;统计儿童心肌桥长度(23.5±15.2)mm,厚度(8.6±6.0)mm;合并HCM 46 例(52.9%);明确记载的行心肌桥松解术 39 例(44.8%);随访时间为 3 个月～10 年,随访中死亡者 7 例,明确记载预后良好的 70 例(81.4%).结论 儿童冠状动脉心肌桥发病时以急性心肌缺血为突出表现,位置以左前降支中段最常见,治疗则是冠脉狭窄程度+Schwarz分型结合临床综合治疗,大多预后良好.
Abstract
Objective To report 2 cases of coronary myocardial bridge in children with acute myocardial ischemia and review the literature.Methods We introduce two cases of coronary myocardial bridging in children.The literature on coronary bridge in children from 1990 to 2021 was searched to obtain the relevant data.SPSS 25.0 and RevMan 5.0 software were used for statistical analysis of the included data.Results A total of 27 literatures were included,including 98 children,61 males and 27 females,with a male to female ratio of 1.6∶1.The age of onset was(12.2±4.9)years.The most common symptom was chest pain in 42 cases(48%).There were 108 segments of myocardial bridge in 98 segments of left anterior descending branch(90.7%).Myocardial bridge length was(23.5±15.2)mm,thickness was(8.6±6.0)mm;46 cases(52.9%)were combined with HCM.In 39 cases(44.8%),bridge lysis was performed.The follow-up period was 3 months to 10 years.7 cases died,and 70 cases(81.4%)had a good prognosis.Conclusion Acute myocardial ischemia is the most prominent manifestation in the onset of coronary artery bridge in children,and the most common location is the middle part of the left anterior descending branch.The treatment is coronary stenosis degree+Schwarz classification combined with clinical comprehensive treatment,and most of the prognosis is good.
维普
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