经桡动脉冠状动脉介入术后桡动脉管径及血流动力学改变

目的探讨经桡动脉冠状动脉介入术前及术后桡动脉管径及血流动力学变化。方法经桡动脉冠状动脉介入手术的139例患者,按疾病类型分为5组,正常组(20例)、高血压组(26例)、血脂异常组(44例)、糖尿病组(22例)、糖尿病合并血脂异常组(合并组,27例)。分别于术前及术后48～72h行右侧桡动脉二维及彩色多普勒血管超声检查,记录右侧桡动脉近段、中段、远段的管径、血流速度。结果桡动脉近段、中段、远段的管径术前与术后比较均无显著差异,术后远段血流速度较术前明显增快,有显著差异(P<0.05),其中糖尿病组、合并组术前远段管径较正常组和高血压组小,有显著差异(P<0.05)。术后48～72h内桡动脉远段穿刺点处管腔轻度狭窄。结论糖尿病和糖尿病合并血脂异常患者经桡动脉冠状动脉介入术前因血管较细,更易出现远段穿刺部位轻度狭窄。

Effects of transradial coronary intervention on diameters and haemodynamics of radial artery

Objective To evaluate effects of transradial coronary interventional procedure on diameter and haemodynamics of radial artery.Methods 139 patients underwent transradial interventional procedure of coronary artery.According to the type of disease,they were divided into normal group(20),hypertension group(26),hyperlipemia group(44),diabetic group(22),hyperlipemia complicating diabetic group(27).Diameters and blood flow velocities of the right radial artery were measured with 2-dimensional and color doppler ultrasound before and after the procedure.Results There were no significant changes of diameters of radial artery after the procedure(P>0.05),but the blood flow velocities of distal radial artery showed significant changes.There were significant changes of diameters and blood flow velocities of distal radial artery after the procedure in 22 diabetic patients,44 hyperlipemia patients and 27 diabetes complicated by hyperlipemia patients.Their distal segment diameters were smaller than those of the normal group before the procedure.Their distal segment diameters decreased and blood flow velocities increased after procedure.Conclusion There was mild stenosis of distal radial artery in 48-72 h after transradial coronary intervention.This phenomenon occurred often in patients with hyperlipoidemia and diabetes whose distal radial artery diameters were small.