经造影导管局部给药对桡动脉痉挛的预防作用

目的：探讨经造影导管肱动脉注射硝酸甘油对经桡动脉冠状动脉介入治疗（TRI）中桡动脉痉挛（RAS）的预防效果。方法连续入选TRI冠状动脉造影（CAG）成功并需行经皮冠状动脉介入治疗（PCI）包括经皮穿刺冠状动脉腔内成形术和（或）支架置入术]患者810例，其中试验组413例，对照组397例。试验组当造影导管回撤到达肱动脉水平时经造影导管注射硝酸甘油稀释液400μg（稀释至100μg/ml），对照组在造影导管抽出后经由鞘管侧管注射硝酸甘油400μg（稀释至100μg/ml），比较两组患者在指引导管送入过程中的RAS发生率。结果试验组较对照组RAS发生率降低，差异有统计学意义（18%比33%，P=0.021）。结论经造影导管肱动脉注射硝酸甘油能降低TRI中RAS的发生率。

The effect of local nitroglycerine application via the angiography catheter on prevention of radial artery spasm

Objective This study aimed to study the effect of intra-brachial nitroglycerin administration via the angiography catheter on radial artery spasm in transradial percutaneous coronary intervention. Methods From patients undergoing transradial percutaneous coronary intervention （TRI） and succeeding in coronary angiography （CAG）, 810 patients who needed percutaneous coronary intervention （PCI） （including Percutaneous Transluminal Coronary Angioplasty and/or stent implantation） were erolled, including 413 patients in the study group and 397 patients in the control group. When coronary angiography completed, positioned the angiography catheter over brachial artery and patients in the group received an administration of 400μg nitroglycerin via the angiography catheter. The control group received an administration of 400μg nitroglycerin via the sheath. The incidence of RAS were recored and compared. Resultes Baseline characteristics were similar between two groups. In the study group, the incidence of RAS was signiifcatively lower （18 vs. 33, P=0.021）. Conclusions Intra-brachial nitroglycerin administration via the angiography catheter can prevent RAS during the insertion of guiding catheter in TRI.