Allen’s实验和超声检查在桡动脉冠状动脉旁路移植术中的临床意义

Clinical significance of Allen's test and color Doppler flow imaging in radial artery coronary artery bypass graft

目的 探讨Allen’s实验和超声检查在桡动脉 (RA)冠状动脉旁路移植术 (CABG)中的重要意义。方法 经Allen’s实验筛选 5 0例桡动脉CABG病例 ,分组比较彩色多普勒血流显像 (CDFI)检查结果。结果 5例桡动脉病理报告为内膜轻度增生 ,其余病例病理检查均正常。CDFI检查 1 1例动脉内膜不规则增厚。CDFI检查动脉内膜增厚组 :收缩期峰值流速 (PSV) (2 6 .90± 7.88)cm/s,舒张末期流速 (EDV) (2 .75± 2 .0 8)cm/s ,时间平均峰值流速 (TAPV) (6 .2 7± 3.4 3)cm/s ,搏动指数 (PI) 7.1 9± 6 .0 0 ;动脉内膜无增厚组 :PSV(35 .5± 1 8.5 )cm/s,EDV(4 .30± 2 .2 4 )cm/s(P <0 .0 5 ) ,TAPV(1 0 .90± 7.1 1 )cm/s(P <0 .0 5 ) ,PI 3.78± 1 .73(P <0 .0 1 )。桡动脉直径 (DRA) :男性 >女性 (P <0 .0 5 ) ,大体重组 >小体重组 (P <0 .0 5 ) ,无糖尿病组 >糖尿病组 (P <0 .0 5 )。高血脂组 :EDV(2 .71± 1 .84 )cm/s,TAPV(6 .95± 1 .36 )cm/s。无高血脂组 :EDV (4 .5 1± 3.2 0 )cm/s (P <0 .0 5 ) ,TAPV(1 1 .2 0± 7.83)cm/s (P <0 .0 5 )。性别、体重、年龄、吸烟、高血压、糖尿病和凝血状态对RA血流动力学无影响。结论 Allen’s实验结合CDFI检查可有效地筛选RA。

Objective To investigate the clinical significance of Allen's test and color doppler flow imaging(CDFI) in radial artery(RA) coronary artery bypass graft.Methods 50 cases of RA CABG were selected by Allen's test,and the results of CDFI were compared.Results The intima of radial artery was gentle hyperplasia in 5 cases,the rest was normal.The results of CDFI:Irregular thickening of intima in 11 cases,The group of intima thickenning:peak systolic velocity(PSV)(26.90±7.88)cm/s,end diastolic velocity(EDV)(2.75±2.08)cm/s,time average peak velocity(TAPV)(6.27±3.43)cm/s,pulsatility index(PI)7.19±6.00;the group of normal intima:PSV(35.5±18.5)cm/s,EDV(4.30± 2.24 )cm/s ( P <0.05),TAPV(10.90±7.11)cm/s( P <0.05),PI 3.78±1.73( P <0.01).Diameter of radial artery(D RA ):male>female( P <0.05),high weight group>low weight group( P <0.05) ,diabetesless group>diabetes group( P <0.05).Hyperlipoidemia group: EDV(2.71±1.84)cm/s,TAPV(6.95±1.36)cm/s.Hyperlipoidemialess group: EDV(4.51±3.20)cm/s ( P <0.05),TAPV(11.20±7.83)cm/s ( P <0.05).The hemodynemics of RA was not affected by sex?weight?age?smoking?hypertension?diabetes and coagulation condition.Conclusions RA could be effectively selected by Allen's test combined with examination of CDFI.In the degree,the examination of CDFI could point out the quality of RA.