冠状动脉-肺动脉瘘的临床和冠状动脉造影特点分析  

Characteristics of coronary artery-pulmonary artery fistula on coronary angiography

作　　者：沈健[1] 陈亮[1] 赵仙先[1] 朱嘉琦[1] SHEN Jian CHEN Liang ZHAO Xianxian ZHU Jiaqi(Department of Cardiology,Changhai Hospital, The Second Military Medical University, Shanghai, 200433, Chin)

机构地区：[1]第二军医大学附属长海医院心内科,上海200433

出　　处：《临床心血管病杂志》2016年第12期1192-1194,共3页Journal of Clinical Cardiology

基　　金：国家自然科学基金面上项目(No:81370266);上海市自然科学基金(No:15ZR1413600)

摘　　要：目的:总结冠状动脉-肺动脉瘘(CPAF)的一般临床特征及其冠状动脉造影特点。方法:回顾性分析冠状动脉造影诊断为CPAF的患者,分别评估患者的基本情况、临床症状与体征、解剖特点(如起源、起源数量以及动脉瘤样变化)等资料。结果:共收集患者93例,其中男54例(58.1%)、女39例(41.9%),年龄(58.7±13.1)岁,89例患者存在胸闷、胸痛、心悸、头晕、呼吸困难等症状,4例患者心前区听诊可闻及杂音,1例可见口唇发绀。冠状动脉造影示CPAF起源于单支冠状动脉者71例(76.3%),起源于2支以上冠状动脉者22例(23.7%)。起源于单支冠状动脉患者中瘘管类型按起源血管的发生比例分别为:左前降支-肺动脉型38例(40.8%)、回旋支-肺动脉型15例(16.1%)、右冠状动脉-肺动脉型8例(8.8%)、第1对角支-肺动脉型5例(5.3%)、左主干-肺动脉型5例(5.3%)。23例(24.7%)有动脉瘤样改变,24例(25.81%)同时被诊断为冠心病。结论:CPAF患者症状多不特异,可伴有各种症状。CPAF可为单一血管起源,也可多支起源;最常见瘘管类型为前降支-肺动脉型,其次为回旋支-肺动脉型。部分CPAF可有动脉瘤样改变。Objective：To evaluate the characteristics of coronary artery-pulmonary artery fistula（CPAF）and the characteristics of coronary angiography.Method：Among the cases of CPAF confirmed by coronary angiography,we retrospectively evaluated the demographics,clinical symptoms and sings,and anatomical characteristics such as the origin,number of origins,and the presence of aneurysmal changes.Result：There were 93 cases of CPAF confirmed by coronary angiography.The patients were 54 men（58.1%）and 39 women（41.9%）with a mean age of（58.7±13.1）years.Eighty-nine patients had symptoms such as chest tightness,angina,palpitations,dizzy and dyspnea.Continuous murmurs could be heard in 4 patients and cyanosis was present in 1 case.The origins of CPAF were single（n=71,76.3%）or multiple（n=22,23.7%）.The single original CPAF arose commonly from left anterior descending（LAD）,left circumflex,right coronary artery,first diagonal branch of the LAD（D1）and left main coronary artery.Twenty-three patients（24.7%）exhibited aneurysmal changes,and 24 patients（25.81%）were diagnosed with coronary artery disease.Conclusion：Patients with CPAF could have various symptoms and signs.The origins of CPAF are single or multiple.The single original CPAF arise most commonly from left anterior descending and left circumflex coronary artery.The CPAFs frequently exhibite aneurysmal changes.

关 键 词：冠状动脉-肺动脉瘘 冠状动脉造影 

分 类 号：R540.4[医药卫生—心血管疾病]