桡动脉痉挛血管扩张剂干预研究

目的以桡动脉造影法观察不同血管扩张剂对桡动脉的解痉效果,明确血管扩张剂对RAS的作用。方法接受经桡动脉途径介入治疗的患者180例。随机分入A组(硝酸甘油200μg),B组(尼卡地平200μg)和C组(硝酸甘油100μg+尼卡地平100μg)各60例。常规桡动脉造影后分别鞘入协定药物。给药后1 min、2 min分别行桡动脉造影。比较3组患者给药前、给药后1 min、2 min桡动脉正常参考段及痉挛段的直径变化。结果对于桡动脉正常参考段,A、B组给药后1 min、2 min直径显著增加(P<0.05);C组在给药后较给药前直径显著增加(P<0.05),但给药后1 min、给药后2 min无显著差异(P>0.05);对于桡动脉痉挛段,各组内给药前、给药后1 min、给药后2 min桡动脉直径均存在显著统计学差异(P<0.05),且给药2min后A组、C组的痉挛段直径显著大于B组(P<0.05)。结论硝酸甘油及尼卡地平均具有明显扩张桡动脉的作用,但2者联合应用有更大优势。

The study of radial artery spasm vasodilator intervention

Objective To explore the effect of different vasodilators on radial artery spasm(RAS) by radial artery angiography.Methods 180 patients undergoing transradial coronary angiography or angioplasty were randomly divided into three groups: group A(nitroglycerin 200 μg),group B(Nicardipine 200 μg) and group C(100 μg of Nicardipine plus 100 μg of nitroglycerin) with 60 patients in each group.The radial arteriography was performed through the sheath at baseline,1 min and 2 min after injection spasmolytic regimen to relieve vasospasms.The diameter of radial artery spasmsegment and the segment of normal reference were compared at baseline,1 min and 2 min after injection of spasmolytic regimen in 3 groups.Results For the diameter of normal reference segment of radial artery,there were significant difference among baseline,1 min and 2 min after injection spasmolytic regimen(P<0.05) in group A and B group.There were significant difference between baseline and 1 min after injection spasmolytic regimen(P<0.05),but no significant difference between 1 min and 2 min after injection spasmolytic regimen in group C(P>0.05).For the diameter of spasm segment,there were significant difference among baseline,1 min and 2 min after injection in each group(P<0.05).There were significant difference 2 min after injection between previous two groups and group B(P<0.05).Conclusion The radial artery can be expanded by nitroglycerin and Nicardipine significantly,but there are greater advantage by two combination.