冠状动脉瘤样扩张的识别与诊断

Identification and diagnosis of coronary artery ectasia

目的探讨冠状动脉瘤样扩张的特点，提高识别与诊断能力。方法对我院11例冠脉造影检查证实的冠状动脉瘤样扩张患者进行症状询问，心电图、心肌酶学、x线胸片、超声心动图检查。结果2例表现为急性心肌梗死，7例心绞痛，2例非典型胸痛。造影显示11例冠状动脉瘤样扩张直径达6～10mm．其中右冠状动脉（RA）7例，左前降支（LAD）4例，左回旋支（LCX）3例；2例扩张血管内血栓形成。结论冠脉以单支血管瘤样扩张为主，右冠多见，其临床表现与冠心病高度相似，冠状动脉影像学检查可尽早确诊。

Objective To explore the characteristics of coronary artery ectasia. Methods 11 cases with coronary artery ectasia proved by angiogram were included and summarized the characters of symptoms, electrocar diogram, myocardial enzymes, chest Xray and echoeardiogram. Results There were 2 patients presenting acute myocardial infarction, 7 cases with angina, 2 cases with mild chest pain. Angiography revealed 11 cases of coro nary artery eetasia diameter up to 6 mm to 10 mm range, in which the right coronary artery （RA） in 7 cases, left anterior descending artery （LAD） in 4 cases, left circumflex artery （LCX） in 3 cases, 2 cases dilated vascular thrombosis. Conclusion Ectasia often locate in single coronary artery, especially in RA. Its clinical manifestations are highly similar to coronary heart disease. Coronary artery imaging examination may be an early diagnosis of the disease.