摘要
目的：探讨高海拔地区单纯冠状动脉扩张（ coronary artery ectasia，CAE）的临床特点及治疗方法。方法回顾性分析来自高海拔地区（2260-4500m）行冠状动脉造影912例患者影像和临床资料。结果912例行冠状动脉造影患者中，共检出单纯CAE 32例，检出率为3.5％；好发部位依次为右冠状动脉26例（41.3％）、左主干17例（27.0％）、前降支13例（20.6％）、回旋支7例（11.1％）。Logistic回归分析显示高血压、高血脂、高血糖、饮酒、海拔＞3500m及血红蛋白升高是单纯CAE的独立危险因素。随访半年期间仍有心绞痛症状发作8例，心律失常2例。结论单纯CAE在冠状动脉造影中可发现，除与冠心病的危险因素有关外，还可能与高原低氧因素有关。患者需长期应用抗血小板药物联合钙拮抗剂、他汀类和曲美他嗪，药物或介入治疗不能控制的高危CAE患者需要手术结扎或切除血管瘤，同时行冠状动脉搭桥术。
Objective To explore the clinical features and treatment methods of isolated coronary artery ectasia （ CAE ） at high altitude by coronary arteriography. Methods Coronary arteriographic images and clinical data of 912 cases from high altitude（ 2 260 - 4 500 m ） were retrospectively analyzed. Results Thirty-two isolated CAE cases were found in 912 coronary arteriographic populations with the incidence of 3. 5%. Right coronary artery（26 cases,41. 3%）,left main coronary artery（17 cases,27%）,anterior descending branch（13 cases,20. 6%）and circumflex（7 cases,11. 1% ） were the predilection sites in turn. Hyperlipidemia,drinking,hypertension, hyperglycemia,altitude and hemoglobinre were the independent risk factors of isolated CAE. Eight cases had still had angina in the half year of follow-up. Conclusion Except the risk factors with coronary heart disease,altitude hypoxia is another factor of isolated CAE. Antiplatelet drugs,calcium antagonists,statins and trimetazidine need long time use for the patients. CAE drug or intervention in high-risk patients who can not control the need for surgical ligation or resection of hemangioma,at the same time the need for bypass operation of coronary artery.
出处
《河北医科大学学报》
CAS
2014年第6期628-630,共3页
Journal of Hebei Medical University
关键词
冠状动脉疾病
高海拔
危险因素
coronary artery disease
altitude
risk factors
