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目的:通过计算机断层扫描血管成像(computed tomography angiography,CTA)了解冠状动脉变异(coronary artery anomalies,CAA)的发生情况,并探讨起源变异与冠状动脉粥样硬化斑块形成的相关性。方法:回顾性分析8 360例冠状动脉CTA检查患者的变异情况。随机抽取78例冠脉起源正常患者作为起源正常组,比较冠状动脉起源变异患者与起源正常患者相同分支上斑块的发生情况。同时比较有冠脉高危解剖特征与无高危解剖特征的冠脉动脉起源变异患者斑块的发生情况。结果:CAA98例,其中起源变异78例,数目变异8例,终止变异4例,结构变异8例。左旋支单独起源于左窦(6例)时,左旋支斑块发生率(60.00%)明显高于起源正常组左旋支上斑块发生率(16.67%),差异有统计学意义(P=0.006);对比有无高危解剖特征的两组的斑块发生率(31例,39.74%和47例,60.26%),差异无统计学意义(P=0.201)。结论:起源变异在所有CAA类型中最常见。起源变异中,左旋支单独起源于左窦是斑块形成的高危因素,应当引起重视并早期干预。
OBJECTIVE: To understand the occurrence of coronary artery anomalies (CAA) by computed tomography angiography (CTA) and to explore the relationship between the origin mutation and coronary atherosclerotic plaque formation. Methods: A retrospective analysis of 8 360 cases of coronary artery CTA patients with variation. A total of 78 patients with normal coronary origin were randomly selected as the normal control group. The incidence of plaques on the same branch of patients with normal coronary origin and normal origin were compared. At the same time, we compared the incidence of plaque in patients with coronary artery origin with high-risk anatomic features of coronary artery and non-high-risk anatomical features. Results: CAA 98 cases, of which 78 cases of genetic variation, the number of mutations in 8 cases, termination of variation in 4 cases, structural variation in 8 cases. When the left circumflex artery originated solely in the left sinus (6 cases), the incidence of left circumflex artery plaque (60.00%) was significantly higher than that of the normal left circumflex artery (16.67%), the difference was statistically significant (P = 0.006 ). The incidence of plaque in both groups (31 cases, 39.74% and 47 cases, 60.26%) with or without high-risk anatomic features was not significantly different (P = 0.201). CONCLUSIONS: Origin variation is most common in all CAA types. In the origin variation, left ventricle branch originated from left sinus is the high risk factor of plaque formation, which should be paid more attention and early intervention.