老年患者冠状动脉扭曲临床特征及相关危险因素

Clinical features and risk factors in elderly patients with coronary tortuosity

目的探讨老年患者冠状动脉（简称“冠脉”）扭曲的病变特点及相关危险因素。方法选取进行冠脉造影检查的304例老年患者为研究对象，回顾性查阅病史资料和影像资料；分析相关危险因素，并对血压水平与冠脉扭曲程度之间相互关系进行分析。结果老年冠脉扭曲阳性率高达55-3％（168／304），老年女性发病率为60．1％（101／168），中重度扭曲主要发生在左回旋支（33．9％），三支病变的扭曲总积分最高；性别与血压是老年患者冠脉扭曲的重要危险因素；血压水平的高低与冠脉扭曲程度呈正相关。结论老年冠脉扭曲发病率高，且与性别、血压密切相关。血压越高造成的冠脉扭曲程度越严重。

Objective To investigate the clinical features and related risk factors of coronary tortuosity in elderly patients. Methods A total of 304 elderly patients, with age over 60 years, including 157 males and 147 females, who underwent coronary angiography in our department during January to June 2010 were enrolled in this study. Coronary angiography and clinical data of all patients were retrospectively reviewed to analyze risk factors and correlation of blood pressure and severity of coronary tortuosity. Results Positive rate of coronary tortuosity was 55.3%（168/304） in the cohort of elderly patients, but the incidence for women was 60.12% （101/168）. Moderate tortuosity was most common in the left circumflex coronary artery （33.9%）. Those with triple-vessel lesions had highest score in tortuosity severity. Gender and blood pressure were the risk factors of coronary tortuosity for the elderly patients. A significant positive correlation was found between blood pressure and coronary tortuosity severity. Conclusion Elderly patients have a high incidence of coronary tortuosity, which have an intimate correlation with gender and blood pressure. The higher the blood pressure is, the more severe the coronary tortuosity.