669例住院冠状动脉扩张(CAE)患者临床特点分析

The Clinical Analysis of 669 Inpatients of Coronary Artery Ectasia(CAE)

目的回顾性分析阜外医院669例住院冠状动脉扩张患者的临床特点,增进对冠状动脉扩张的认识。方法 2009年1月1日至2014年5月5日连续有106305位患者在北京阜外医院住院行冠状动脉造影,收集冠脉造影发现的冠状动脉扩张患者共697例,取其中病历资料完整的669例进行临床分析。结果冠状动脉扩张患病率为0.656%,单纯性冠状动脉扩张占冠状动脉扩张的10.31%。冠状动脉扩张共累及878支冠状动脉,好发部位依次为右冠状动脉主支(41.80%),前降支主支(25.40%),回旋支主支(21.64%),及左主干(4.78%)。冠状动脉扩张患者大部分为男性(84.75%),吸烟者占31.99%,伴高血压者占34.68%,伴高脂血症者占31.54%,而伴糖尿病者仅占11.36%。22.12%的冠状动脉扩张患者有心肌梗死病史,23.77%的冠状动脉扩张患者有冠状动脉支架植入史。实验室检验结果显示,40%以上冠状动脉扩张患者血浆总甘油三酯偏高,70%以上血浆低密度脂蛋白胆固醇偏高,而20%以上总胆固醇偏低;30%以上脂蛋白(a)偏高;36.62%的患者高敏C反应蛋白偏高。结论冠状动脉扩张的患病率较低,最多累及右冠状动脉主支,多见于男性,除糖尿病外与冠状动脉危险因素相似,大多数冠状动脉扩张患者血脂水平控制不良。冠状动脉扩张可能与炎性反应相关。

Objective To retrospectively analyze the clinical characteristics of 669 patients with coronary artery ectasia（CAE） in Fu Wai hospital for further study of CAE. Methods From January 1st 2009 to May 5th 2014, 106305 consecutive patients underwent coronary angiography at Fu Wai hospital.The clinical characteristics of 669 CAE patients with intact medical records were analyzed. Results The prevalence of CAE was 0.656%,and isolated CAE was observed in 10.31% CAE patients. There were totally 878 dilated coronary arteries, and the main branch of right coronary artery（RCA） was mostly involved（41.80%）,followed by the main branch of left anterior descending artery（LAD）（25.40%）,the main branch of left circumflex artery（LCX）（21.64%）,and the left main coronary artery（LM）（4.78%）.Of our CAE patients, 84.75% were male, 31.99% smokers, 34.68% with hypertension, 31.54% with hyperlipidemia,but only 11.36% with diabetes.22.12% CAE patients had previous myocardial infarction,and 23.77% underwent coronary stent implantation previously.The laboratory tests showed that,more than 40% CAE patients had higher triglyceride,more than 70% had higher low-density lipoprotein cholesterol,and more than 30% had higher lipoprotein（a）,but more than 20% had lower cholesterol. 36.62% CAE patients had higher highsensitivity C-reactive protein. Conclusions CAE had relatively rare prevalence with RCA mostly involved.The risk factors of CAE were similar as coronary atherosclerotic disease except diabetes.Most CAE patients had abnormal blood lipid level,and CAE might relate to inflammation.