冠心病患者经桡动脉介入治疗术后桡动脉闭塞的危险因素分析

Risk Factors Analysis of Radial Artery Occlusion after Radial Artery Interventional Therapy in Patients with Coronary Heart Disease

目的 探讨冠心病患者经桡动脉介入治疗术后桡动脉闭塞(radial artery occlusion,RAO)的危险因素。方法 回顾性收集2019年1月—2021年12月邹城市人民医院行经桡动脉介入治疗的260例冠心病患者的临床资料,根据是否发生RAO分为RAO组(n=33)和非RAO组(n=227),对影响患者术后RAO的单因素、多因素进行分析。结果 单因素分析显示:体质指数、冠心病分型、冠状动脉病变数量、冠心病家族史、吸烟史、脑梗死病史、置入支架数量与冠心病患者经桡动脉介入治疗术后RAO无关,差异无统计学意义(P>0.05);性别、年龄、高血压、糖尿病、血脂异常、桡动脉穿刺置管时间与冠心病患者经桡动脉介入治疗术后RAO有关,差异有统计学意义(P<0.05)。多因素分析显示:年龄≥60岁(β=1.285,OR=3.613,95%CI=1.671~7.814)、女性(β=1.012,OR=2.750,95%CI=1.307~5.786)、高血压(β=0.842,OR=2.320,95%CI=1.057~5.096)、糖尿病(β=0.885,OR=2.424,95%CI=1.125~5.222)、血脂异常(β=0.934,OR=2.545,95%CI=1.204~5.280)、桡动脉穿刺置管时间≥20h(β=1.808,OR=6.099,95%CI=1.807~20.592)是RAO独立危险因素。结论 年龄≥60岁、女性、高血压、糖尿病、血脂异常、桡动脉穿刺置管时间长是冠心病患者经桡动脉介入治疗术后RAO的危险因素,临床应予以高度重视。

Objective To explore the risk factors of radial artery occlusion(RAO)in patients with coronary heart disease after percutaneous radial artery intervention.Methods Clinical data of two hundred and sixty patients with coronary heart disease who underwent radial artery interventional therapy in the hospital from January 2019 to December 2021 were retrospectively collected and divided into RAO group(n=33)and non-RAO group(n=227)according to whether RAO occurred.Univariate and multivariate analysis of postoperative RAO were performed.Results Univariate analysis showed that body mass index,coronary heart disease type,number of coronary artery lesions,family history of coronary heart disease,smoking history,history of cerebral infarction,number of stents implanted were not related to RAO after radial artery intervention in patients with coronary heart disease,and there was no significant difference(P>0.05).Sex,age,hypertension,diabetes,dyslipidemia,time of radial artery catheterization were related to RAO after radial artery intervention in patients with coronary heart disease,and the difference was statistically significant(P<0.05).Multivariate analysis shows that age≥60 years old(β=1.285,OR=3.613,95%CI=1.671-7.814),female(β=1.012,OR=2.750,95%CI=1.307-5.786),hypertension(β=0.842,OR=2.320,95%CI=1.057-5.096),diabetes(β=0.885,OR=2.424,95%CI=1.125-5.222),dyslipidemia(β=0.934,OR=2.545,95%CI=1.204-5.280)and radial artery puncture and catheterization time ≥20 h (β=1.808, OR=6.099, 95%CI=1.807-20.592) were independent risk factor forRAO. Conclusion Age ≥60 years old, female, hypertension, diabetes, dyslipidemia, and long duration of radial arterycatheterization are risk factors for RAO in patients with coronary heart disease after radial artery interventionaltherapy, which should be paid close attention to clinically.