口服尼可地尔预防桡动脉途径介入诊疗中桡动脉痉挛作用的临床研究  

Clinical study of the preventive role of oral nicorandil on artery spasm in transradial radial interventing treatment

作　　者：高波[1] 贺莉[1] 肖杰[1] 刘涛[1] 李论[1] 顾晔[1] 

机构地区：[1]武汉市普爱医院心内科,武汉430030

出　　处：《临床心血管病杂志》2014年第6期495-497,共3页Journal of Clinical Cardiology

摘　　要：目的:观察术前应用尼可地尔口服制剂在经桡动脉途径介入诊疗中预防桡动脉痉挛(radial artery spasm,RAS)的疗效及安全性。方法:选择经桡动脉途径介入检查和治疗的患者400例,随机分成尼可地尔组(术前给予尼可地尔片5mg口服)和对照组,比较两组RAS发生率,并观察尼可地尔的不良反应。结果:实际入选病例分为尼可地尔组198例,对照组199例。完成单纯冠状动脉(冠脉)造影(CAG)和冠脉介入治疗(CAG+PCI)的例数,两组无统计学差异。行单纯CAG,尼可地尔组RAS发生率低于对照组(9.7%︰20.8%,P<0.05);行CAG+PCI,尼可地尔组与对照组RAS发生率差异无统计学意义(17.2%︰23.2%,P>0.05);但总和RAS发生率,尼可地尔组与对照组比较,差异有统计学意义(12.1%︰21.6%,P<0.05)。尼可地尔组不良反应发生率低且轻微。结论:经桡动脉途径冠脉介入诊疗术前口服尼可地尔能安全、有效地预防单纯CAG桡动脉痉挛的发生,但不能有效预防CAG+PCI桡动脉痉挛。Objective：To observe the effectiveness and the security of oral nicorandil beiore intervention treat- ment on the preventing of radial artery spasm. Method：All 400 patients （transradial approach involves examination and treatment） were randomly divided into nicorandil group （preoperative nicorandil tablets, 5 mg p. o） and con- trol group. RAS records , the incidence and outlook, and adverse reactionswere compared. Result： The patients were actually enrolled into nicorandil group with 198 cases, 199 cases in control group. There were no angiography alone （CAG） and percutaneous coronary intervention （CAG ＋ PCI） between two groups. With simple CAG, the RAS incidence was lower in nicorandil group than that in control group （9.7% vs 20.8%, P〈0.05） ; With CAG ＋ PCI, there was no statistically significant difference between two groups （17.2% vs 23.2%, P〉0.05） ; There was statistically significant in total incidence of RAS between nicorandil group and control group （12.1 % vs 21. 6%, P〈0.05）. The adverse reactions in nicorandil group was low and mild. Conclusion：The oral nicorandil treat- ment before transradial coronary intervention is safe, simple and effective in preventing the occurrence of CAG ra- dial artery spasm but not effective in preventing CAG ＋ PCI radial artery spasm.

关 键 词：桡动脉痉挛 桡动脉途径 介入诊疗 尼可地尔 口服 

分 类 号：R541.4[医药卫生—心血管疾病]