中国循证心血管医学杂志
中國循證心血管醫學雜誌
중국순증심혈관의학잡지
CHINESE JOURNAL OF EVIDENCE-BASES CARDIOVASCULAR MEDICINE
2013年
6期
599-601
,共3页
冠状动脉扩张%介入治疗%预后
冠狀動脈擴張%介入治療%預後
관상동맥확장%개입치료%예후
Coronary artery ectasia%Interventional therapy%Prognosis
目的：研究冠状动脉扩张（CAE）患者的临床特点及近期预后。方法纳入2009年1月~2011年10月2258例因典型或不典型胸痛行冠脉造影（CAG）患者的影像资料进行回顾性分析，共发现CAE患者102例，通过多元回归分析，分析年龄、性别、吸烟史、高血压病和糖尿病与CAE的相关性，按照是否合并狭窄分为单纯冠状动脉扩张组（n=25）和冠状动脉扩张合并狭窄组（n=77），进一步将CAE合并狭窄患者按照所采用的治疗策略不同分为介入治疗亚组和药物治疗亚组，对所有CAE患者随访2年，评价主要心血管事件（MACE，包括再发心绞痛、心肌梗死、死亡）发生率有无差异。结果 CAE发生率4.52％（102/2258），扩张合并狭窄较单纯扩张更为常见（75.50%vs.24.50％）。多元回归分析结果显示，男性是CAE的独立危险因素（OR=3.32；95%CI：1.80~6.20）。单纯扩张组与扩张合并狭窄组MACE发生率无明显差异（37.5%vs.32.0%，P＞0.05）；但在扩张合并狭窄组中，介入治疗亚组患者的MACE发生率显著低于药物治疗亚组（15.09%vs.72.73%，P＜0.01）。结论 CAE常与狭窄同时存在，更好发于男性，CAE预后与是否合并狭窄无关，但对于合并狭窄的患者，及时采用介入治疗能够改善近期预后。
目的：研究冠狀動脈擴張（CAE）患者的臨床特點及近期預後。方法納入2009年1月~2011年10月2258例因典型或不典型胸痛行冠脈造影（CAG）患者的影像資料進行迴顧性分析，共髮現CAE患者102例，通過多元迴歸分析，分析年齡、性彆、吸煙史、高血壓病和糖尿病與CAE的相關性，按照是否閤併狹窄分為單純冠狀動脈擴張組（n=25）和冠狀動脈擴張閤併狹窄組（n=77），進一步將CAE閤併狹窄患者按照所採用的治療策略不同分為介入治療亞組和藥物治療亞組，對所有CAE患者隨訪2年，評價主要心血管事件（MACE，包括再髮心絞痛、心肌梗死、死亡）髮生率有無差異。結果 CAE髮生率4.52％（102/2258），擴張閤併狹窄較單純擴張更為常見（75.50%vs.24.50％）。多元迴歸分析結果顯示，男性是CAE的獨立危險因素（OR=3.32；95%CI：1.80~6.20）。單純擴張組與擴張閤併狹窄組MACE髮生率無明顯差異（37.5%vs.32.0%，P＞0.05）；但在擴張閤併狹窄組中，介入治療亞組患者的MACE髮生率顯著低于藥物治療亞組（15.09%vs.72.73%，P＜0.01）。結論 CAE常與狹窄同時存在，更好髮于男性，CAE預後與是否閤併狹窄無關，但對于閤併狹窄的患者，及時採用介入治療能夠改善近期預後。
목적：연구관상동맥확장（CAE）환자적림상특점급근기예후。방법납입2009년1월~2011년10월2258례인전형혹불전형흉통행관맥조영（CAG）환자적영상자료진행회고성분석，공발현CAE환자102례，통과다원회귀분석，분석년령、성별、흡연사、고혈압병화당뇨병여CAE적상관성，안조시부합병협착분위단순관상동맥확장조（n=25）화관상동맥확장합병협착조（n=77），진일보장CAE합병협착환자안조소채용적치료책략불동분위개입치료아조화약물치료아조，대소유CAE환자수방2년，평개주요심혈관사건（MACE，포괄재발심교통、심기경사、사망）발생솔유무차이。결과 CAE발생솔4.52％（102/2258），확장합병협착교단순확장경위상견（75.50%vs.24.50％）。다원회귀분석결과현시，남성시CAE적독립위험인소（OR=3.32；95%CI：1.80~6.20）。단순확장조여확장합병협착조MACE발생솔무명현차이（37.5%vs.32.0%，P＞0.05）；단재확장합병협착조중，개입치료아조환자적MACE발생솔현저저우약물치료아조（15.09%vs.72.73%，P＜0.01）。결론 CAE상여협착동시존재，경호발우남성，CAE예후여시부합병협착무관，단대우합병협착적환자，급시채용개입치료능구개선근기예후。
Objective To study the clinical characteristics and short-term prognosis in patients with coronary artery ectasia (CAE).Methods The patients (n=2258) with typical or atypical chest pain and CAG examination were chosen from Jan. 2009 to Oct. 2011, and their image data was retrospectively analyzed. There were totally 102 patients with CAE selected. The correlation between age, sex, smoking history, hypertension and diabetes and CAE was analyzed through multiple regression analysis. The patients were divided into simple CAE group (n=25) and CAE complicating stenosis group (n=77), and further CAE complicating stenosis group was divided into intervention subgroup and drug treating subgroup. All patients were followed up for 2 years. The incidence of MACE (including angina pectoris, myocardial infarction and death) were reviewed.Results The incidence of CAE was 4.52% (102/2258), and CAE complicating stenosis was more common compared with simple CAE (75.50%vs. 24.50%). The multiple regression analysis showed that male was an independent risk factor of CAE (OR=3.32;95%CI: 1.80-6.20). The incidence of MACE had no significant difference between simple CAE group and CAE complicating stenosis group (37.5%vs. 32.0%,P>0.05), but in CAE complicating stenosis group, it was significantly lower in intervention subgroup than that in drug treating subgroup (15.09%vs. 72.73%,P<0.01).Conclusion CAE is commonly accompanied by stenosis and prevalent in male patients. The prognosis of CAE is not correlated to stenosis complication, but timely intervention treatment can improve the short-term prognosis in the patient with CAE complicating stenosis.
