图尔荪江·纳曼,李国庆,程慧

• 1:新疆医科大学研究生学院
• 2:新疆维吾尔自治区人民医院心内科

摘要(Abstract)：

目的探讨桡动脉血管解剖变异的发生率及其临床预测因素。方法入选2016年1月1日至6月30日在新疆维吾尔自治区人民医院心内科首次接受经桡动脉入径冠心病介入诊疗的1731例患者。记录所有患者相关基本信息及相关病史,均先行经右侧桡动脉入径桡动脉造影,据桡动脉变异的定义记录动脉解剖变异情况且分桡动脉入径变异组和桡动脉入径正常组。采用单因素和多因素Logistic回归分析各因素对患者桡动脉血管解剖变异的预测价值。结果 1731例患者中桡动脉血管解剖变异86例(4.97%)其中男性47例,女性39例。桡动脉入径变异组中桡动脉痉挛的发生率33.72%(29/86),而桡动脉入径正常组中桡动脉痉挛发生率2.74%(45/1645),两组比较差异有统计学意义(P<0.001),在桡动脉入径变异组中经右侧桡动脉介入诊疗的失败率26.74%(23/86),而在桡动脉入径正常组中其失败率为1.51%(25/1645),两组比较差异有统计学意义(P<0.001),经右侧桡动脉入径介入诊疗的总体成功率97.23%(1683/1731)。女性、身高低、低体重、高脂血症、吸烟、饮酒、职业等方面两组比较差异有统计学意义(P<0.05),而糖尿病、体重指数、高血压病、民族等方面两组比较差异无统计学意义(P>0.05)。多元Logistic回归分析显示:年龄、性别、高脂血症、职业是农民与桡动脉变异的发生有显著相关性(P<0.05),年龄每增加10岁、桡动脉发生变异的风险增加0.264倍(OR1.264,95%CI 1.006~1.587;P=0.044),女性桡动脉发生变异的风险是男性的3.999倍(OR 3.999,95%CI 2.241~7.136;P<0.001),有高脂血症患者桡动脉发生变异的风险是无高脂血患者的1.776倍(OR 1.776,95%CI 1.011~3.122;P=0.046),职业是农民患者桡动脉发生变异的风险是其他职业患者2.188倍(OR 2.188,95%CI 1.238~3.867;P=0.007)。结论桡动脉变异的发生率低,高龄、女性、身高低、低体重、高脂血症、吸烟、饮酒、职业是农民与桡动脉变异的发生密切相关,进行多因素Logistic回归分析提示高龄、女性、高脂血症、职业是农民与桡动脉变异的存在具有显著相关性,对是否存在桡动脉变异有一定的预测价值。

关键词(KeyWords)： 桡动脉变异;预测因素;经桡动脉入径介入治疗

Abstract:

Keywords:

基金项目(Foundation): 新疆维吾尔自治区自然科学基金项目(2017D01C133)

作者(Author): 图尔荪江·纳曼,李国庆,程慧

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