冠状动脉扩张的临床表现及影像学特点

目的 研究冠状动脉(冠脉)扩张的临床表现及其影像学特点.方法 收集2005-2007年在北京协和医院行冠脉造影的患者,入选冠脉扩张患者25例进行研究.并按日期配对入选冠脉粥样硬化组25例和冠脉造影正常对照组25例.结果 冠脉扩张患者大部分为男性(72%).只有3例患者合并糖尿病,13例患者合并了高血压.所有患者均以胸痛入院,其中9例有ST段改变,4例为ST段抬高.冠脉扩张患者中最常受累的血管是右冠脉(76%),其次为左前降支(60%),左回旋支(48%)和左主干(8%);其中单支受累的患者占44%,而3支受累者占36%.与粥样硬化相比,冠脉扩张患者中糖尿病的发病率较低(冠脉扩张组合并糖尿病为12%,粥样硬化组为48%,正常组为16%),其他危险因素如高血压、血脂等各组差异无统计学意义.结论 冠脉扩张以男性好发,合并糖尿病较低,右冠脉为最常受累血管,而且以单支受累为主.

The clinical manifestations and angiographic characteristics of coronary artery ectasia

Objective To retrospectively analyze the clinical manifestations of coronary artery ectasia and its angiographic characteristics. Methods Twenty-five patients who underwent coronary angiography were diagnosed as coronary artery ectasia from January 2005 to December 2007. 25 cases of coronary artery atheresclerosis were also included and 25 cases with normal coronary arteriography in the same period were taken as control. Results Most of the patients were male (72%). Only three patients had diabetes and thirteen patients had hypertension. All the patients with coronary artery ectasia were admitted for chest pain. Nine of them showed abnormal ST changes and four elevated ST in ECG. Coronary artery ectasia was associated with slow coronary flow in 9 patients and coronary stenosis in 4 patients. The frequency of arterial involvement, in descending order, was right coronary artery in 76%, left anterior descending artery in 60%, left circumflex artery in 48% and left main artery in 8%. Ectasia affected only one major vessel was found in 44%, and all three vessels in 36%. As compared with the patients with coronary artery atherosclerosis and patients with normal coronary artery, patients with CAE had a lower prevalence of diabetes (12%), and there were no other significant statistics in clinical demography and other risk factors such as hypertension and dyslipidemia. Conclusions Coronary artery ectasia was prevalent in males and diabetes was less frequent. The RCA was the most commonly affected vessel and most of the patients had single vessel involvement.