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目的 冠状动脉扩张性病变(CAE,coronary artery ectasia)是一种冠状动脉扩张为主的血管病变,扩张的冠脉直径大于附近正常血管的1.5倍.文章概述CAE的发病机制、临床危害、与冠状动脉粥样硬化性心脏病(CAD,coronary artery disease)的区别、与全身其他血管扩张的关联、治疗的特殊之处.方法 以近年来CAE相关临床、基础研究文献,概述CAE的研究进展.结果 CAE在冠脉造影中的检出率为1-5％,粥样硬化、炎症反应是其主要发病机制;CAE可对冠脉血流动力学产生不良影响而被认为是有害的冠脉病变;粥样硬化重、特定的ACE、MMP基因型、不合并糖尿病的CAD患者更容易出现CAE;治疗上CAE与CAD基本类似,但不适合用硝酸酯类等药物.结论 CAE是一种有临床危害的不同于CAD的冠脉病变,需要临床重视及针对病因进行干预.“,”Objective Coronary artery ectasia is characterized by inappropriate dilatation of the coronary vasculature.The most commonly used angiographic definition of CAE is the diameter of the ectatic segment being more than 1.5 times larger compared with an adjacent healthy reference segment.There have been some clinical and basic researches about the exact mechanism of its development,untoward outcome,the difference with CAD,coexist with artery ectasia of other vessels.We give a review then.Methods According to recent documents on clinical characters,mechanism of its development,the relationship with coronary atherosclerosis,the prognostic factors and treatment strategies.Results CAE has been found in 1-5％ during coronary angiography.Coronary atherosclerosis and inflammation are the major mechanism of CAE.People who get CAE may have heavier atherosclerosis burden and specific gene type such as 5A/5Agenotype of MMP-3,which indicate a bad outcome.hsCRP,aortic dilation may have prognosis value in CAE.Researches about treatment are rare,secondary prevention of coronary heart disease may applies to CAE.Conclusion CAE is different from CAD,and may indicate bad outcome.More attention should be paid into its diagnosis,prognosis and treatment.