经桡动脉冠脉介入治疗中桡动脉痉挛发生的相关因素

The factors related to radial artery spasm occurring in percutaneous coronary intervention via radial artery access

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的可能危险因素。方法2012年1月—2013年4月,选取经桡动脉途径行冠心病介入诊疗患者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 239例中,59例(20.1%)发生桡动脉痉挛。多元Logistic回归分析显示女性(OR=3.093,P=0.034)、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。

Objective To explore the possible risk factors in relation to radial artery spasm （RAS） occurring in percutaneous coronary intervention via radial artery access.Methods During the period from Jan.2012 to Apr.2013 at the hospital,a total of 293 patients （162 males and 131 females） underwent transradial coronary angiography （CAG） and/or percutaneous coronary intervention （PCI）.The clinical data and angiographic characteristics were analyzed.Multivariate Logistic regression analysis was adopted to evaluate the variables.Results RAS occurred in 59 （20.1%） patients.Logistic regression analysis showed that RAS correlated with the following five factors：female （OR =3.093 ; P =0.034）,hyperlipoidemia （OR =2.897; P =0.023）,smoking （OR =3.894; P =0.009）,anatomical abnormality of radial artery （OR =3.590; P =0.005） and moderate-to-severe pain of forearm during radial artery cannulation （OR =5.393; P 〈 0.001）.Conclusion Female,hyperlipoidemia,smoking,anatomical abnormally of radial artery and moderate-tosevere pain of forearm during radial artery cannulation are possible risk factors causing RAS in percutaneous coronary intervention.