冠状动脉瘤样扩张在冠心病患者中的临床特征分析

Clinical study of characteristics analysis of coronary aneurysmal dilatation in patients with coronary heart disease

目的探讨冠状动脉瘤样扩张(CAE)在冠心病患者中的临床特征。方法回顾性分析2009年1月至2014年9月在温州医科大学附属台州医院连续住院的3068例接受冠状动脉造影诊断为冠心病的患者,统计CAE的发病率及可能的相关因素。结果CAE在冠心病患者中的发生率为3.68%。在113例患者中共有受累的冠状动脉149支,单支扩张病变最常见(82.30%),以右冠状动脉最多(40.94%)。与非CAE组相比CAE组尿酸水平、高血压患病率均高于前者(t/χ^(2)=4.638、2.980,P<0.05),通过Logistic回归分析发现尿酸是冠心病人群中CAE的相关因素[OR(95%CI)=0.997(0.994~0.999),P<0.05]。Pearson相关性分析提示瘤样扩张比率(1.50~4.42,1.97±0.46)与每日吸烟支数(r=0.273,P<0.05)、吸烟指数(r=0.214,P<0.05)相关。结论冠心病患者中CAE的检出率为3.68%,右冠状动脉为最易受累冠状动脉,且多为单支血管受累,尿酸是CAE的危险因素,而血管的扩张程度与吸烟量有关。

Objective To investigate the clinical characteristics of coronary artery ectasia(CAE)in patients with coronary heart disease(CHD).Methods Retrospective analysis was conducted on 3068 consecutive patients diagnosed with CHD by coronary angiography who were admitted to Taizhou Hospital Affiliated to Wenzhou Medical University from January 2009 to September 2014.The incidence of CAE and the possible related factors were analyzed.Results The incidence of CAE in patients with coronary heart disease was 3.68%.A total of 149 coronary arteries were involved in 113 patients.Among them,Single branch dilatation was the most common lesion(82.30%),and the right coronary artery was the most common involved(40.94%).Compared with the non-CAE group,the level of uric acid and prevalence of hypertension in the CAE group were higher than those in the non-CAE group(t/χ^(2)=4.638,2.980;P<0.05).Multivariate regression analysis showed that plasma uric acid was a related factor of CAE[OR(95%CI)=0.997(0.994-0.999),P<0.05].Pearson correlation analysis indicated that the ratio of localized or diffuse dilated coronary artery diameter to adjacent normal coronary artery(1.50-4.42,1.97±0.46)was related to number of cigarettes per day(r=0.273,P<0.05)and smoking index(r=0.214,P<0.05).Conclusion The prevalence of CAE in patients with obstructive coronary artery disease is 3.68%.The right coronary artery is most commonly affected and most patients has single vessel involvement.Increased serum uric acid level is a risk factor for pres CAE.The severity of CAE dilation may be correlated with the smoking amount.