冠状动脉瘤样扩张的特点及危险因素  

Characteristics and risk factors of coronary artery ectasia

作　　者：王丽娜 孙小刚 马娜 WANG Li-na;SUN Xiao-gang;MA Na(Department of Cardiology,Second People's Hospital of Gansu Province,Lanzhou 730000,China)

机构地区：[1]甘肃省第二人民医院心内科,730000

出　　处：《中国实用医药》2022年第22期11-14,共4页China Practical Medicine

基　　金：甘肃省卫生健康行业科研计划(项目编号:GSWSKY2020-47)。

摘　　要：目的探讨冠状动脉瘤样扩张的发病特点及危险因素。方法1190例因胸痛行冠状动脉造影(冠脉造影)检查的患者,筛选出其中冠状动脉瘤样扩张(CAE)患者102例作为CAE组,阻塞性冠状动脉疾病(OCAD)的患者102例为OCAD组,冠状动脉正常者102例为对照组。对比三组的临床特点(性别、年龄、吸烟史、高血压病史、糖尿病、冠心病家族史)及生化指标[总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、超敏C反应蛋白(hs-CRP)、血尿酸(UA)],通过Logistic回归分析发生CAE的危险因素。结果1190例冠脉造影患者中CAE患者102例,发病率为8.6%。累及单支血管88例(86.3%),其中右冠55例(53.9%)、前降支18例(17.6%)、回旋支15例(14.7%);累及两支血管10例(9.8%),累及三支血管4例(3.9%)。三组的男性占比、年龄、吸烟史、高血压病史、糖尿病、TC、LDL-C比较,差异均无统计学意义(P>0.05);OCAD组和对照组的冠心病家族史占比比较差异无统计学意义(P>0.05)。CAE组的TG、hs-CRP、UA水平及冠心病家族史占比均高于OCAD组和对照组,差异均有统计学意义(P<0.05);OCAD组的TG、hs-CRP、UA水平均高于对照组,差异均有统计学意义(P<0.05)。将冠心病家族史(是=1,否=0)、TG、UA、hs-CRP纳入多因素Logistic回归模型,结果显示:冠心病家族史、TG、UA、hs-CRP是发生CAE的独立危险因素(P<0.05)。通过Logistic回归分析表明,冠心病家族史、TG、hs-CRP、UA为冠状动脉瘤样扩张的危险因素。结论CAE在右冠、单支血管中发生率最高。冠心病家族史、TG、hs-CRP、UA是发生CAE的危险因素。全面了解冠状动脉瘤的发病特点,快速、有效的识别CAE的危险因素,从危险因素中准确的评估患者病情,为患者早期诊断争取更多的时机并采取针对性的防治就显得尤为重要。Objective To discuss the characteristics and risk factors of coronary artery ectasia.Methods Of the 1190 patients who underwent coronary angiography for chest pain,102 patients with coronary artery ectasia(CAE)were selected as CAE group,102 patients with obstructive coronary artery disease(OCAD)were selected as OCAD group,and 102 patients with normal coronary arteries were selected as control group.The clinical characteristics(gender,age,history of smoking,history of hypertension,diabetes mellitus,and family history of coronary artery disease)and biochemical indicators(total cholesterol(TC),triglyceride(TG),low-density lipoprotein cholesterol(LDL-C),high-sensitivity C-reactive protein(hs-CRP),and serum uric acid(UA)]of the three groups were compared,and the risk factors of CAE were analyzed by Logistic regression analysis.Results Among the 1190 patients with coronary angiography,102 patients had CAE,and the incidence rate was 8.6%.88 cases(86.3%)involved a single vessel,including 55 cases(53.9%)in the right coronary artery,18 cases(17.6%)in anterior descending artery,and 15 cases(14.7%)in left circumflex artery;10 cases(9.8%)involved two vessels and 4 cases(3.9%)involved three vessels.There was no statistically significant difference in the proportion of males,age,smoking history,history of hypertension,diabetes mellitus,TC and LDL-C among the three groups(P>0.05).The difference in the percentage of family history of coronary heart disease between the OCAD group and control group was not statistically significant(P>0.05).The TG,hs-CRP,UA levels and the percentage of family history of coronary heart disease in the CAE group were higher than those in the OCAD group and control group,and the differences were all statistically significant(P<0.05).The TG,hs-CRP,and UA levels in the OCAD group were higher than those in the control group,and all differences were statistically significant(P<0.05).Family history of coronary heart disease(yes=1,no=0),TG,UA,and hs-CRP were included in a multifactorial Logistic regression mo

关 键 词：冠状动脉瘤样扩张 阻塞性冠状动脉疾病 临床特点 危险因素 

分 类 号：R541.4[医药卫生—心血管疾病]