成人冠状动脉扩张的临床特点及相关因素分析

Clinical characteristics and risk factors of coronary artery ectasia in adults

目的研究冠状动脉扩张发病的临床特点、发生率及相关的危险因素。方法从3 443例住院并行选择性冠状动脉造影术的患者中筛选出68例冠状动脉扩张患者作为CAE组,并采用随机数字表法随机选出72例阻塞性冠状动脉疾病患者（OCAD组）及70例冠状动脉正常患者（NCA组）作为对照,对比分析3组的临床特点及生化指标。结果冠状动脉扩张的发生率为1.98%,其中右冠状动脉发生率最高,占所有冠状动脉扩张患者总数的54.41%;其次为前降支,为20.59%;冠状动脉两支扩张的发生率为7.35%,冠状动脉三支同时发生扩张的概率为10.29%。通过分析发现,CAE患者空腹血糖水平明显低于OCAD患者,差异有统计学意义（P〈0.05）。CAE组与NCA组比较冠状动脉扩张男性比例高,CAE组患者在年龄及脂蛋白a水平明显高于NCA组患者,差异均有统计学意义（P〈0.05）。Logistic回归分析表明,男性、高龄及高脂蛋白a水平为冠状动脉扩张的危险因素（性别：OR=3.299,95%CI 1.529-7.119,P=0.002;年龄：OR=1.041,95%CI 1.001-1.082,P=0.045;脂蛋白a：OR=1.020,95%CI 1.003-1.037,P=0.023）。结论成人冠状动脉扩张在右冠状动脉发生率最高,男性、高龄及高脂蛋白a水平是成人冠状动脉扩张发生的危险因素。

Objective To investigate the clinical characteristics, incidence and risk factors of coronary artery ectasia （CAE）. Methods In total, 3 443 hospitalized patients undergoing elective coronary angiography were retrospectively analyzed. Among them, 68 patients diagnosed with CAE were selected and assigned into the observation group. Seventy two patients with obstructive coronary artery disease （OCAD） and 70 with normal coronary artery （NCA） were allocated into the control group by random number table method. Clinical characteristics and biochemical indexes were statistically compared between three groups. Results The incidence of CAE was 1.98%, mainly in the right coronary artery with an incidence rate 54. 41% among all patients, followed by anterior descending branch （20. 59% ）. The incidence of CAE in two branches of the coronary artery was 7.35% , and 10. 29% for three branches of the coronary artery. The level of fasting plasma glucose （FPG） in patients with CAE was significantly lower than that in OCAD counterparts （P 〈 0. 05 ）. In CAE group, we found that the incidence of male of coronary artery ectasia was significantly higher than NCA group. The age of CAE patients was significantly older and the lipoprotein a level was considerably higher compared with those of NCA counterparts （ P 〈 . 05 ）. Logistic regression analysis revealed that the risk factors of CAEwere male （OR =3.299, 95%CI 1.529-7. 119, P=0.002）, old age （OR=1.041, 95%CI 1.001- 1. 082, P = 0. 045 ） and high level of LP （a） （ OR = 1. 020, 95 % CI 1. 003-1. 037, P = 0. 023 ）. Conclusions The incidence of CAE is the highest in the right coronary artery. Male gender, old age and high level of lipoprotein a are risk factors of the incidence of CAE in adults.