老年腹主动脉瘤患者冠状动脉造影的临床意义

Incidence and risk factors of coronary artery disease in elderly patients with abdominal aortic aneurysm

目的 探讨老年腹主动脉瘤患者中冠心病（CAD）的检出率及其相关危险因素.方法 回顾性分析70例50岁以上同时进行腹主动脉造影和冠状动脉造影的老年腹主动脉瘤患者的临床资料及影像学资料,应用x2检验,多因素logistic回归等方法对数据进行统计和分析.结果 70例患者中,检出CAD 63例（90.0%）,其中单支病变20例（28.6%）,2支病变15例（21.4%）,3支病变22例（31.4%）,左主干＋3支病变6例（8.6%）;多因素logistic回归分析显示,周围血管病是老年腹主动脉瘤合并CAD的最重要预测因素.结论 50岁以上腹主动脉瘤,尤其是合并周围血管病的患者是CAD高发人群,因此在腹主动脉造影时应常规进行冠状动脉造影检查,以免漏诊CAD.

Objective To explore the prevalence of coronary artery disease and risk factors in patients with abdominal aortic aneurysm（AAA）.MethodsCoronary angiography was performed immediately after abdominal angiography in 70 elderly（〉50 years）consecutive patients with AAA. Medical history and imaging characteristics were evaluated. Results CAD was diagnosed in 63 patients（90. 0%）by coronary angiography： 20（28.6%）patients with single-vessel disease（SVD）, 15（21.4%）with 2VD, 22（31.4%）with 3VD and 6（8. 6%）with left main disease ＋ 3VD. Multi-variance logistic analysis showed that peripheral disease was the strongest predictor for CAD in AAA patients. Conclusion Coronary angiography should be performed in elderly AAA patients due to the high prevalence of CAD in this patient cohort.