经桡动脉冠脉介入中桡动脉痉挛发生的相关因素分析

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1、经桡动脉冠脉介入中桡动脉痉挛发生的相关因素分析Theanalysisaboutrelatedriskfactorsofradialarteryspasmintransradialcoronaryintervention郑望魏易洪邓兵周端李广浩Author(s):ZHENGWang；WEIYihong；DENGBing；ZHOUDuan；LIGuanghaoShanghaiUniversityofTraditionalChineseMedicineDepartmentofCardiology,LonghuaHospital,shanghai200032,China作者单位：200032上海

2、市，上海中医药大学附属龙华医院心内科通讯作者：李广浩，E-mail:shanxianlgh@sina.comCorrespondingauthor:LIGuanghao【摘要】目的探讨经桡动脉行冠状动脉（冠脉）介入诊疗中桡动脉痉挛发生可能的危险因素。方法选取经桡动脉途径行冠心病介入诊疗的患者293例，记录所有患者的病史资料及冠脉造影特征，均经桡动脉行冠脉造影术（CAG）或冠脉介入治疗（PCI）。应用Logistic回归模型分析各因素对冠心病介入诊疗过程中桡动脉发生痉挛的影响。结果59例（20.1%）患者发生桡动脉痉挛。多元Logistic回归分析显示女性（OR=3.093；P=0.034

3、）、高脂血症（OR=2.897；P=0.023）、吸烟史（OR=3.894；P=0.009）、桡动脉鞘置入时前臂疼痛（OR=5.393；P＜0.001）、桡动脉路径解剖异常（OR=3.590；P=0.005）是桡动脉痉挛发生的独立危险因素。结论女性、高脂血症、吸烟、桡动脉路径解剖异常、术中前臂疼痛是桡动脉痉挛发生的可能相关危险因素。【关键词】桡动脉痉挛；经桡动脉途径；介入；相关性Theanalysisaboutrelatedriskfactorsofradialarteryspasmintransradialcoronaryintervention【Abstract】ObjectiveT

4、oexplorethepossibleriskfactorscausingradialarteryspasm(RAS)intransradialcoronaryintervention.MethodsTheclinicaldataandangiographiccharacteristicswerecollectedin293patients(162malesand131females)whounderwenttransradialcoronaryangiography(CAG)orpercutaneouscoronaryintervention(PCI).MultivariateLogi

5、sticregressionanalysiswasadoptedtoevaluatethevariables.ResultsRASoccurredin59(20.1%)patients.LogisticregressionanalysisshowedthatRAScorrelatedwiththefollowingfivefactorswhicharefemalegender(OR=3.093;P=0.034),Hyperlipidemia(OR=2.897;P=0.023),smoking(OR=3.894;P=0.009),anatomicalabnormalitiesinradia

6、lartery(OR=3.590;P=0.005),moderate-to-severepainofforearmduringradialarterycannulation(OR=5.393;P＜0.001).Conclusionfemalegender,Hyperlipidemia,smoking,anatomicalabnormalitiesinradialarteryandmoderate-to-severepainofforearmduringradialarterycannulationarepossibleriskfactorscausingRASinarteryinterv

7、ention.【keywords】radialarteryspasm;transradialapproach;intervention;correlation随着介入治疗技术的不断发展进步以及器械的不断更新，经桡动脉冠状动脉介入治疗(transradialcoronaryintervention,TRI)已成为冠心病介入治疗中首选或占绝对多数的途径[1-3]。但桡动脉较股动脉内径小，易发生桡动脉痉挛(radialarteryspas