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冠状动脉扩张是一种冠状动脉疾病,可表现为弥漫性扩张和局限性冠状动脉瘤,冠状动脉造影检出率波动在1.4%-9.9%。冠状动脉扩张的病因有动脉粥样硬化、川崎病、结缔组织病、大动脉炎、先天性心脏病及少数感染性疾病,近年来介入相关性冠状动脉扩张发生率逐渐增加。冠状动脉扩张的发病机制尚不完全清楚,动脉粥样硬化起主要作用,炎症反应、细胞外基质降解及基因易感性均可能不同程度的参与了冠状动脉扩张的发生发展。冠状动脉扩张发病男性多于女性,临床表现无特异性,多表现为心绞痛。冠状动脉造影是诊断冠状动脉扩张的主要手段,影像学检查如超声、冠脉CT和MRI等也有一定的诊断价值。冠状动脉扩张的药物治疗强调慢性抗栓治疗,注意避免应用硝酸酯类药物,介入治疗多为个案报道,手术治疗相对预后良好,但选择优化的治疗方案仍具有挑战性。
Coronary artery dilatation is a coronary artery disease that manifests as diffuse dilatation and localized coronary aneurysms with a 1.4% -9.9% detection rate of coronary angiography. The causes of coronary artery dilatation include atherosclerosis, Kawasaki disease, connective tissue disease, arteritis, congenital heart disease and a few infectious diseases. In recent years, the incidence of coronary artery dilatation involving intervention has gradually increased. The pathogenesis of coronary artery dilatation is not yet fully understood, atherosclerosis plays a major role, inflammation, extracellular matrix degradation and gene susceptibility may be involved in varying degrees of coronary artery dilatation. Coronary artery dilatation incidence of more men than women, non-specific clinical manifestations, the performance of angina. Coronary angiography is the main means of diagnosis of coronary artery dilation, imaging studies such as ultrasound, coronary CT and MRI, also have some diagnostic value. Drug therapy for coronary artery dilation emphasizes chronic antithrombotic therapy, attention should be given to avoid nitrates, interventional treatment is mostly reported, and surgical treatment is relatively good prognosis, but the optimal treatment options are still challenging.