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目的探讨经皮冠状动脉介入治疗(percutaneous coronary intervention,PCI)后肱动脉血流介导血管舒张功能(flow-mediated dilation,FMD)的变化及意义。方法选择2014年1月—2015年12月收治的经桡动脉途径行PCI的患者150例,观察桡动脉痉挛及闭塞情况,均于术前及术后测量左、右两侧肱动脉FMD及桡动脉内径。计量资料比较采用t检验,计数资料比较采用χ~2检验,动脉痉挛及闭塞的影响因素用Logistic回归进行分析。P<0.05为差异有统计学意义。结果FMD、桡动脉内径、导管数量及造影剂用量是PCI术后肱动脉痉挛及闭塞的影响因素(均P<0.05)。右侧(手术侧)肱动脉FMD PCI手术前后比较差异有统计学意义(P<0.05);术后左右侧肱动脉FMD FMD值比较差异有统计学意义(P<0.05)。右侧(手术侧)桡动脉内径手术前后比较差异有统计学意义(P<0.05);术后左右侧桡动脉内径值比较差异有统计学意义(P<0.05)。结论 FMD值对预测动脉痉挛及闭塞有着重要的预测价值。
Objective To investigate the changes of brachial artery-mediated flow-mediated dilation (FMD) after percutaneous coronary intervention (PCI). Methods From January 2014 to December 2015, 150 patients undergoing transradial PCI were enrolled. The radial spasm and occlusion were observed. The brachial artery FMD and radius were measured before and after operation Arterial diameter. Measurement data were compared using t test, count data were compared using χ ~ 2 test, the factors affecting arterial spasm and occlusion were analyzed by Logistic regression. P <0.05 for the difference was statistically significant. Results The frequency of FMD, the diameter of the radial artery, the number of catheters and the amount of contrast medium were the influencing factors of brachial artery spasm and occlusion after PCI (all P <0.05). There were significant differences in FMD FMD between right and left brachial artery before and after FMD PCI (P <0.05). There was significant difference in FMD FMD between right and left brachial artery (P <0.05). There were significant differences in the diameter of the radial artery on the right side (operation side) before and after operation (P <0.05). There was significant difference in the diameter of the left and right radial artery after operation (P <0.05). Conclusion FMD value has important predictive value for the prediction of arterial spasm and occlusion.