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目的总结分析行冠状动脉造影诊断为冠状动脉扩张(coronary artery ectasia,CAE)患者的临床特征及病变特点,以提高CAE的综合诊治水平。方法回顾性分析我院2009年10月～2010年1月行冠状动脉造影诊断CAE15例的临床资料。结果本组表现为急性心肌梗死5例,心前区不适4例,典型发作性胸痛及仅有乏力、头晕各3例。合并高血压病及高脂血症各10例,高尿酸血症3例,腹主动脉瘤2例,慢性乙肝1例。冠状动脉造影结果按照Markis分型,8例为多支弥漫性冠状动脉扩张(Ⅰ型);5例为局限性冠状动脉瘤(Ⅳ型);2例为单根血管弥漫性病变(Ⅲ型),呈冠状动脉瘤样扩张。结论临床仅少数CAE适合实施介入治疗。加强危险因素控制,普及冠状动脉造影及多排CT检查,积极予抗凝、抗栓及预防痉挛等治疗,并适时行介入治疗有利于提高CAE的诊治水平。
Objective To summarize and analyze the clinical features and pathological features of coronary artery ectasia (CAE) in patients undergoing coronary angiography to improve the comprehensive diagnosis and treatment of CAE. Methods The clinical data of 15 cases with CAE diagnosed by coronary angiography in our hospital from October 2009 to January 2010 were retrospectively analyzed. Results This group showed 5 cases of acute myocardial infarction, 4 cases of precordial discomfort, typical episodes of chest pain and only weakness, dizziness in 3 cases. 10 cases of hypertension and hyperlipidemia, 3 cases of hyperuricemia, 2 cases of abdominal aortic aneurysm and 1 case of chronic hepatitis B, respectively. The results of coronary angiography were classified according to Markis classification, 8 cases were multiple diffuse coronary arteries (type Ⅰ), 5 cases were localized coronary aneurysms (Ⅳ), 2 cases were single vessel diffuse lesions (Ⅲ) , Was coronary aneurysmal-like dilatation. Conclusions Only a few CAEs are suitable for interventional therapy. To strengthen the control of risk factors, the popularization of coronary angiography and multi-slice CT examination, positive to anticoagulant, antithrombotic and prevention of spasm and other treatment, and timely intervention is conducive to improve the diagnosis and treatment of CAE levels.