贾德安,周玉杰,赵迎新,王建龙,王志坚,杨士伟,刘晓丽,葛海龙,胡宾,陈艺

• 1:首都医科大学附属北京安贞医院十二病房

摘要(Abstract)：

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。

关键词(KeyWords)： 血管成形术,经腔,经皮冠状动脉;维拉帕米;硝酸甘油;桡动脉痉挛

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 贾德安,周玉杰,赵迎新,王建龙,王志坚,杨士伟,刘晓丽,葛海龙,胡宾,陈艺

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