中国南方人群桡动脉造影验证血管解剖变异及其预测因素

Angiography verification and clinical predictors of anatomical variations of radial artery in the southerner of China

背景:关于中国南方人群桡动脉路径血管迂曲、变异的流行病学调查研究,目前尚未见报道。目的:探讨中国南方人群桡动脉路径血管发生解剖变异的风险及其临床预测因素。方法:入选首次经桡动脉入路行冠心病介入诊疗的中国南方患者1400例。记录所有患者病史资料,均行桡动脉路径动脉造影,记录动脉解剖变异情况,再行下一步的冠脉造影或冠脉介入治疗。应用Logistic回归模型分析各因素对患者桡动脉路径血管解剖变异的预测价值。结果与结论:动脉造影发现中国南方人群桡动脉路径血管解剖变异以锁骨下动脉和桡动脉迂曲最为多见。经桡动脉途径介入诊疗总体成功率约为96.1%。在桡动脉路径血管解剖变异患者中,经桡动脉介入诊疗的失败率达15.1%,而在桡动脉路径正常患者中其失败率约为1.8%,两者比较差异有显著性意义(P<0.001)。多元Logistic回归分析显示年龄、女性、身高、体质量指数、高血压、高脂血症及吸烟,是桡动脉路径血管解剖变异的独立预测因素。

BACKGROUND： There has rarely reported about the epidemiological study on vascular tortuosity and variation of radia artery in the southerner of China. OBJECTIVE： To investigate the incidence and clinical predictors of arterial anatomical variations of radial artery approach （RAA） in the southerner of China. METHODS： Totally 1 400 patients who underwent first-time transradial coronary procedures were included in this study. A detailed patient history was recorded. Radial arteriography was performed in all patients to detect the anatomic variations of this vessel. And then coronary angiography or percutaneous coronary intervention was undertaken. Multivariate Logistic regression analysis was performed to evaluate the predictive value of variables in arterial variations of RAA. RESULTS AND CONCLUSION： For people in southern China, the tortuosity of subclavian artery and radial artery was most common among vascular anatomic variations of the RAA. The overall rate of transradial procedural success rate was 96.1%. Procedural failure rate was more common in patients with anomalous RAA than in patients with normal RAA （15.1% vs 1.8%, P 〈 0.001）. According to multivariate Logistic regression analysis, age, female gender, height, body mass index, hypertension, hyperlipidemia and smoking were independently associated with arterial anatomical variations of RAA.