论文部分内容阅读
目的在使用维拉帕米的基础上,观察维拉帕米加量或联用硝酸甘油预防经桡动脉介入诊疗中桡动脉痉挛(rad ial artery spasm,RAS)的效果。方法前瞻性入选经桡动脉冠状动脉介入治疗的患者,按照随机、双盲原则将患者分为A组(维拉帕米200μg)、B组(维拉帕米1 mg)和C组(维拉帕米200μg+硝酸甘油200μg)。在动脉鞘管置入后,随机给予不同药物。使用造影证实的临床RAS定义。记录并比较各组患者RAS和不良反应的发生率。结果共入选患者621例,其中A组205例、B组206例、C组210例。三组患者的基线资料比较,差异均无统计学意义。单因素方差分析显示,A组患者RAS发生率高于B组(17.1%比10.2%,P=0.045)和C组(17.1%比9.5%,P=0.029),B组和C组间差异无统计学意义(10.2%比9.5%,P=0.870)。Logistic回归分析显示,B组和C组比A组发生RAS相对风险分别降低了32.1%(P=0.038)和43.8%(P=0.017)。不良反应A组和C组相似,均较少。B组不良反应发生率高于A组(9.7%比2.4%,P=0.003)和C组(9.7%比3.8%,P=0.019)。结论在经桡动脉介入诊疗中,推荐国人使用维拉帕米200μg+硝酸甘油200μg预防RAS,该剂量安全、有效,且不良反应较少。
OBJECTIVE To observe the effect of verapamil combined with nitroglycerin on the prevention of radial artery spasm (RAS) in the treatment of transradial intervention based on the use of verapamil. Methods We prospectively enrolled patients undergoing transradial coronary intervention who were randomized into two groups: group A (verapamil 200 μg), group B (verapamil 1 mg) and group C Pam 200 μg + nitroglycerin 200 μg). After the arterial sheath is inserted, different drugs are given randomly. Use a clinically confirmed RAS definition. Record and compare the incidence of RAS and adverse reactions in each group. Results A total of 621 patients were enrolled in this study, including 205 patients in group A, 206 patients in group B and 210 patients in group C. Three groups of patients with baseline data, the difference was not statistically significant. One-way analysis of variance showed that the incidence of RAS in group A was higher than that in group B (17.1% vs 10.2%, P = 0.045) and C (17.1% vs 9.5%, P = 0.029) Statistical significance (10.2% vs. 9.5%, P = 0.870). Logistic regression analysis showed that the relative risks of RAS in group B and group C were reduced by 32.1% (P = 0.038) and 43.8% (P = 0.017), respectively, compared with group A. Adverse reactions A group and C group similar, less. The incidence of adverse reactions in group B was higher than those in group A (9.7% vs 2.4%, P = 0.003) and C (9.7% vs 3.8%, P = 0.019). Conclusion In the transradial interventional therapy, it is recommended that people use verapamil 200μg + 200μg nitroglycerin to prevent RAS, the dose is safe and effective, and the adverse reaction is less.