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中华临床医师杂志(电子版) ›› 2017, Vol. 11 ›› Issue (12) : 1946 -1950. doi: 10.3877/cma.j.issn.1674-0785.2017.12.007

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综述

冠状动脉扩张临床特征及诊断治疗和预后
刘锐锋1, 梁思文1, 高翔宇1, 邸北冰1, 张悦1, 化冰1, 赵慧强1,()   
  1. 1. 100050 首都医科大学附属北京友谊医院心血管内科
  • 收稿日期:2017-03-06 出版日期:2017-06-15
  • 通信作者: 赵慧强
  • 基金资助:
    国家自然科学基金青年基金(81600276)

Clinical features, diagnosis, treatment, and prognosis of coronary artery ectasia: a systematic review

Ruifeng Liu1, Siwen Liang1, Xiangyu Gao1, Beibing Di1, Yue Zhang1, Bing Hua1, Huiqiang Zhao1,()   

  1. 1. Department of Cardiology, Beijing Friendship Hospital Affiliated to Capital Medical University, Beijing 100050, China
  • Received:2017-03-06 Published:2017-06-15
  • Corresponding author: Huiqiang Zhao
  • About author:
    Corresponding author: Zhao Huiqiang, Email:
引用本文:

刘锐锋, 梁思文, 高翔宇, 邸北冰, 张悦, 化冰, 赵慧强. 冠状动脉扩张临床特征及诊断治疗和预后[J]. 中华临床医师杂志(电子版), 2017, 11(12): 1946-1950.

Ruifeng Liu, Siwen Liang, Xiangyu Gao, Beibing Di, Yue Zhang, Bing Hua, Huiqiang Zhao. Clinical features, diagnosis, treatment, and prognosis of coronary artery ectasia: a systematic review[J]. Chinese Journal of Clinicians(Electronic Edition), 2017, 11(12): 1946-1950.

冠状动脉扩张(CAE)定义为冠状动脉管腔局限性或弥散性扩张,其直径超过正常范围的1.5倍。其主要临床表现为心绞痛及心肌梗死,病理表现类似于冠状动脉粥样硬化性心脏病(冠心病),冠状动脉中层破坏是其特征性表现;存在冠状动脉慢血流及微循环障碍现象;冠状动脉造影是目前诊断的金标准;治疗上对于大部分患者建议参照冠心病治疗方案予以个体化治疗,硝酸酯类药物应该避免使用;预后上其两年死亡率与三支病变的冠心病患者相当。

Coronary artery ectasia (CAE) is defined as the inappropriate dilatation of a coronary artery, with the luminal diameter 1.5 or more times wider than that of adjacent normal segments. The main clinical manifestations of CAE are angina and myocardial infarction, and its pathological manifestations are characterized by an extensive destruction of musculoelastic elements, particularly elastin fibers, which are the predominant components of the extracellular matrix of the coronary wall. There is obviously slow coronary blood flow and microcirculation dysfunction in dilated coronary artery. Coronary angiography is the gold standard for CAE diagnosis, and treatments for coronary artery disease (CAD) are recommended for most CAE patients in an individualized manner, but nitrates should be avoided. The prognosis of CAE patients is similar to that of CAD patients with lesions of the three main coronary arteries.

表1 CAE的常用分类方法
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