桡动脉血动力学及其影响因素的分析

Analyse of hemodynamics and affecting factor to radial artery

目的 :分析桡动脉 (RA)血动力学及其影响因素。方法 :对 5 0例桡动脉冠状动脉旁路移植术 (CABG)病例进行术前超声检查 ,测定血流动力学指标 ,分组比较分析。结果 :5例桡动脉病理为内膜轻度增生 ,其余病例病理检查均正常。彩色多普勒血流显像 (CDFI)检查 11例动脉内膜不规则增厚。CDFI检查动脉内膜增厚组 :糖尿病和高脂血症病人数明显增加 (P <0 0 5 )。收缩期峰值流速 (PSV) (2 6 9± 7 88)cm/s ,舒张末期流速 (EDV) (2 75±2 0 8)cm/s ,平均流速 (TAPV) (6 2 7± 3 43 )cm/s ,搏动指数 (PI) 7 19± 6 0 0 ;动脉内膜无增厚组 :PSV (3 5 5± 18 5 )cm/s (P <0 0 5 ) ,EDV(4 3 0± 2 2 4)cm/s (P <0 0 5 ) ,TAPV(10 9± 7 11)cm/s (P <0 0 5 ) ,PI (3 78± 1 73 ) (P <0 0 1)。男性组 :桡动脉直径 (DRA) (2 60± 0 43 )mm ,女性组 :DRA(2 18± 0 5 6)mm(P <0 0 5 ) ;大体重组 :DRA(2 67± 0 45 )mm ,小体重组 :DRA(2 2 9± 0 45 )mm(P <0 0 5 ) ;性别和体重对RA血动力学无影响。年龄和吸烟对RA直径和血动力学无影响。糖尿病组 :DRA(2 2 0± 0 44 )mm ,无糖尿病组 :DRA(2 60± 0 46)mm(P <0 0 5 ) ;糖尿病对RA血流动力学无明显影响。

Objective To study the hemodynamics of radial artery (RA) and analyze its factors. Methods Fifty patients of radial artery-coronary artery by p ass grafting RA-CABG were examined with Color Do ppler Flow Imaging (CDFI) prior to operation. the results of CDFI were compared and analyzed according to different groups. Results According to pathological dia gnosis, the intima of radial artery was gentle hyperplasia in 5 cases, the rest were normal. CDFI examination showed irregular thickening of intima in 11 cases, significant increase in the patients with diabetes and hyperlipoidemia (P<0 .05). Peak systolic velocity (PSV) was (26.9±7.88) cm/s vs (35.5±18.5 ) cm/s (P<0.05), End-diastolic velocity (EDV) (2.75±2.08) cm/s vs ( 4.30±2.24) cm/s (P<0.05), Time average peak velocity (TAPV) (6.27±3.4 3) cm/s vs (10.9±7.11) cm/s (P<0.05) and Pulsatility index (PI) 7.1 9±6.00 vs 3.78±1.73 (P<0.01) in the thickening intima group and the normal inti ma group. Diameter of radial artery (DRA): male>female (P<0.05), high b ody weight group>low body weight group (P<0.05), diabetesless group>diabe tes 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 (11.2±7.83) cm/s (P<0.05). The hemodynemics of RA was not af fected by Sex, body weight, age, smoking, hypertension, diabetes and coagulation conditio n. Conclusion The quality of RA could be primarily estimated by CDFI. The application of RA with irregular thickening of intima, especially acco mpanying by diabetes and Hyperlipoidemia, should be deliberatively considered. S ex, body weight, age, smoking, hypertension and coagulation conditions did not a ffect the application of RA.