老年人冠状动脉起源异常研究

Anomalous origin of coronary artery in elderly adults： classification and incidence

目的分析老年人冠状动脉起源异常的类型及检出率，总结其冠状动脉分布的优势情况，并探讨冠状动脉起源异常与冠状动脉粥样硬化的关系。方法回顾性分析北京大学第一医院接受冠状动脉造影检查的老年患者资料，记录冠状动脉起源异常的检出频度和类型，及发生冠状动脉粥样硬化性狭窄的情况。结果冠状动脉造影总数2031例，检出冠状动脉起源异常46例（2．3％）。右冠状动脉起源异常26例（56．5％），右冠状动脉起源异常多于左冠状动脉（19例，41．3％）。其中以右冠状动脉起源于左冠状动脉窦为最常见类型，占总异常的28．3％（13例）。并存冠状动脉粥样硬化性狭窄者37例（80．4％），其中17例（37．0％）累及起源异常的冠状动脉。结论我国老年人冠状动脉起源异常多见于右冠状动脉，其中具有潜在临床危险的右冠状动脉起源于左冠状动脉窦为最常见类型。冠状动脉起源异常与冠状动脉粥样硬化存在相关性。

Objective To estimate the patterns and frequency of anomalous coronary origin with angiography in the Chinese elderly population and evaluate the correlation between anomalous coronary origin and development of coronary atherosclerotic stenosis. Methods A retrospective analysis was performed on the basis of angiographic data among elderly patients who underwent coronary arteriography in Beijing University First Hospital. Those with anomalous origin of coronary arteries were selected for further assessment and significant stenosis in coronary arteries was recorded. Results Among 2031 patients, 46 patients were found to have anomalous origin of coronary artery, with an incidence rate of 2.3%. Right coronary artery was the most common anomalous vessel, being involved in 26 patients （56.5%）. The anomalous origin was more frequent in right coronary artery than in left coronary artery （41.3%）. The most common anomaly was right coronary artery arising from left coronary sinus in 13 patients （28.3%）. Significant atherosclerotic lesions in the anomalous arteries were seen in 37 patients （80.4%）. Conclusions In Chinese elderly population, the anomalous origin of coronary artery is more frequent in right coronary artery, the most common anomaly resides in right coronary artery arising from left coronary sinus. The anomalous coronary artery increases risk for development of coronary atheroselerotic stenosis.