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38例冠状动脉心肌桥飞行员病例分析

作者：任斌

单位：民航华东地区管理局航空人员体检鉴定中心上海 200336

分类号：R541.4

出版年,卷(期):页码：2010,21(10):0-0

摘要：

摘要目的：探讨冠脉心肌桥飞行员的临床特征以及飞行人员冠脉心肌桥与航空卫生安全的关系。方法：152例运动平板心电图为阳性或可疑阳性的飞行员经冠脉CTA检查，发现38例为冠状动脉心肌桥。将38例冠状动脉心肌桥的飞行员根据有无伴随症状、冠脉心肌桥变异位置、心电图有无异常、有无伴随心血管疾病易患因素及有无伴发冠脉粥样硬化病变作回顾性统计分析。将同在左前降支存在心肌桥变异的冠脉与无心肌桥变异的冠脉分组作对比，比较两组冠脉中出现冠状动脉粥样硬化的病例数，并作统计学分析。结果：38例冠脉心肌桥飞行员中，临床上无症状,其多数静息心电图正常，大多属Nobte分级Ⅰ级,且心肌桥均为表浅型；部分心肌桥合并存在冠心病危险因素；左前降支心肌桥所在动脉及其近端动脉出现动脉粥样硬化者占30.3%（A组），左前降支无心肌桥冠脉出现动脉粥样硬化者占13.2%（B组），两组存在显著性差异（p＜0.05）。结论：冠状动脉心肌桥的飞行员，目前多数无临床症状，心肌桥变异位置多数在左前降支中段，多为表浅型，Nobte分级为I，临床上无需治疗；对于存在冠心病危险因素的飞行员应积极预防及控制这些冠心病危险因素；但心肌桥可继发冠脉的粥样硬化，对于存在冠脉心肌桥的飞行员应引起足够的重视。

Abstract Objective: To investigation the clinical characteristics of myocardial bridging of pilots and the relationship between myocardial bridging of pilote and aviation health security. Methods: 152 cases with sub-maxiaml load ECG check positive or probable positive pilots do CTA examination, which found 38 cases for myocardial bridging. To do a retrospective analysis of statistics of 38 cases pilots coronary myocardial bridging according to whether followed symptom and the variation location of myocardial bridging and whether the electrocardiogram exceptionally, whether followed the cardiovascular disease factors, whether there is to accompany easily send the crown arteries gruel type hardening pathological change. Will be the same in the left anterior descending coronary artery with or without myocardial bridging coronary and make contrasts two group, compare the two sets of coronary atherosclerosis occurs in a number of cases, and for statistical analysis. Results: 38 cases of coronary myocardial bridging pilots clinically no symptoms, most of its normal resting ECG, Nobte ratings are I class and myocardial bridging are superficial; Myocardial bridge merge existing risk factors of coronary heart disease; Left anterior descending coronary artery with myocardial bridging, 30.3% of them with atherosclerotic arterial which is located myocardial bridge and its proximal artery(A group), the left anterior descending coronary artery without myocardial bridges, of which appears in case of atherosclerosis is 13.2% (B group ), the difference between the two groups exist significant (p ＜0.05). Conclusions: Pilots who with myocardial bridging currently mostly have no clinical symptoms, Where the majority of myocardial bridging variations are in the left anterior descending coronary artery,and they are the superficial, Nobte rating I class and need no clinical treatment; For those pilots who have the risk factors of coronary heart disease should prevention and control of those risk factors for coronary artery disease; Myocardial bridging can lead coronary atherosclerosis, we should bring to the enough attention to regarding the existence crown arteries cardiac myocardial bridging pilots.

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参考文献：

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