右冠状动脉起源于左冠状动脉窦走形于主肺动脉间的临床特点  

Clinical characteristics of patients with anomalous origin of right coronary artery from aorta

作　　者：武英彪 罗俊 方明 田蓓 方钞 吴启源 朱洛宁 宁忠平 WU Yingbiao;LUO Jun;FANG Ming;TIAN Bei;FANG Chao;WU Qiyuan;ZHU Luoning;NING Zhongping(Department of Cardiology;Department of Radiology,Shanghai Pudong New District Zhoupu Hospital,Shanghai 201318,China)

机构地区：[1]浦东新区周浦医院心内科,上海201318 [2]浦东新区周浦医院放射科,上海201318

出　　处：《国际心血管病杂志》2018年第4期229-232,共4页International Journal of Cardiovascular Disease

基　　金：浦东新区卫计委优青人才培养(PWRq2015-25);上海市医学重点专科建设(ZK2015A13)

摘　　要：目的:分析右冠状动脉起源于左冠状动脉窦(左冠窦)且走形于主肺动脉间的临床特点。方法:纳入2014年4月至2016年12月在浦东新区周浦医院进行双源CT冠状动脉成像和冠状动脉造影,确诊为右冠状动脉起源于左冠窦且走形于主肺动脉间的患者共32例,对其临床特点进行回顾性分析。结果:CT显示冠状动脉近段与主动脉壁夹角为5°~29°,平均夹角为14.19°±4.66°;32例患者中,冠脉造影显示右优势型者23例(71.87%),同侧冠状动脉粥样硬化18例(56.25%);血管内超声显示患者右冠状动脉平均受压长度为(13.59±4.99)mm,受压管腔平均最小横截面积为(10.24±3.49)mm2;管腔面积狭窄指数为0.496±0.125,管腔偏心指数为0.717±0.168。右冠状动脉起源于左冠窦者好发于男性,主动脉夹角与冠状动脉近端管腔狭窄率呈负相关(r=-0.85,P<0.01)。结论:冠状动脉CT成像可以明确右冠状动脉起源于左冠状窦且走形于主肺动脉之间的冠状动脉畸形。Objective：The study aims to analyze the clinical characteristics of patients with anomalous origin of right coronary artery from aorta（ARCA-A）in Zhoupu Hospital from Apr.2014 to Sep.2016 during coronary intervention procedure. Methods：Thirty-two angiograms of ARCA-A were distinguished from 9 570 patients by intravascular unltrasound（IVUS）,coronary angiographic examination（CAG）and 128-slice spiral computed tomography（MSCT）.Their clinical characteristics were retrospectively analyzed. Results：MSCT showed that the angle between proximal coronary artery and aortic wall was 5°~29°,14.19°±4.66°for average in32 cases.CAG showed that 23 cases had right coronary artery（RCA）and 18（56.25%）of which had the side of coronary atherosclerosis（LCA）.The results of IVUS showed that the average compression length of RCA was（13.59±4.99）mm,the average minimum cross-sectional area（CAS）was（10.24±3.49）mm2;the lumen stenosis index was0.50±0.13,and the luminal eccentricity was 0.72±0.17.Male patients were apt to suffer from ARCA-A.There was a negative correlation between the aortic angle and the stenosis rate of proximal coronary artery（r=0.85,P〈0.01）. Conclusions：MSCT,CAG and IVUS could estimate the risk of ARCA-A,and CAG is necessary to further evaluate the situation of coronary atherosclerosis.

关 键 词：血管畸形 冠状动脉 左冠状动脉窦 

分 类 号：R54[医药卫生—心血管疾病]