硝酸甘油联合维拉帕米预防经皮冠状动脉介入治疗中桡动脉痉挛的临床研究

目的研究经桡动脉路径行经皮冠状动脉介入(PCI)治疗时联用硝酸甘油和维拉帕米预防桡动脉痉挛的有效性及安全性。方法300例冠心病患者随机分为对照组和实验组。对照组鞘管内注入生理盐水10ml;实验组注入硝酸甘油200μg加维拉帕米2.5mg,观察注药前及注药后2、5、10、30min患者的血压、心率及桡动脉痉挛的发生情况。结果对照组发生桡动脉痉挛31例(20.67%),实验组发生桡动脉痉挛7例(4.67%),实验组发生桡动脉痉挛明显低于对照组(P<0.001)。实验组注药前、后心率及舒张压的差异均无显著性(P>0.05);注药前、后收缩压的差异有显著性(P<0.05),注药后不同时间点组间收缩压的差异均无显著性(P>0.05)。结论硝酸甘油200μg联合维拉帕米2.5mg预防经桡动脉路径行PCI中桡动脉痉挛是有效和安全的。

A clinical study of nitroglycerin combined with verapamil in prevention radial artery spasm from percutaneous coronary intervention

Objective To study the efficacy and safety of nitroglycerin combined with verapamil when injected into the radial artery in order to prevent radial artery spasm(RAS) during percutaneous coronary intervention(PCI) with trans-radial approach.Methods 300 patients with coronary artery disease(CHD) were divided randomly into 2 groups,control group was given intrathecal injection with normal saline 10ml,experimental group was given nitroglycerin 200μg plus verapamil 2.5mg.The heart rate and the blood pressure were recorded at 2 min,5 min,10 min and 30 min before and after drug administration.And the incidence of RAS was compared.Results 31 cases(20.67%) had RAS in control group,7 cases(4.67%) had RAS in experimental group,compared control group with experimental group,the incidence of RAS in experimental group was lower,there was statistically significant difference(P<0.001).In experimental group,the heart rate and diastolic blood pressure(DBP) before drug administration did not differ from after drug administration(P>0.05);but before intrathecal injection,the systolic blood pressure(SBP) was statistically higher than after injection(P<0.05).Compared experimental group to control group,there were not statistically significant differences in SBP at different time points after nitroglycerin and verapamil were injected(P>0.05).Conclusion Nitroglycerin 200μg plus verapamil 2.5mg with radial artery injection can prevent RAS effectively and safely during the trans-radial approach for PCI.