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经桡动脉介入治疗后桡动脉远段动脉肥厚:一项系列血管内超声研究。

Distal radial arterial hypertrophy after transradial intervention: A serial intravascular ultrasound study.

机构信息

The Division of Cardiology, Japan Community Healthcare Organization Tokuyama Central Hospital, Shunan, Yamaguchi, Japan.

The Division of Cardiology, Japan Community Healthcare Organization Tokuyama Central Hospital, Shunan, Yamaguchi, Japan.

出版信息

J Cardiol. 2018 Dec;72(6):501-505. doi: 10.1016/j.jjcc.2018.05.008. Epub 2018 Sep 13.

DOI:10.1016/j.jjcc.2018.05.008
PMID:30219614
Abstract

BACKGROUND

Transradial intervention (TRI) may cause damage to the radial artery (RA). We have demonstrated intima-media thickening and luminal narrowing of the distal RA after TRI using intravascular ultrasound (IVUS). This study aimed to determine the predictors of intima-media thickening of RA after TRI in the same patients using serial IVUS.

METHODS AND RESULTS

We enrolled 110 consecutive patients who underwent TRI. IVUS of RA was immediately performed after TRI and repeated 6 months later. Volumetric analyses were performed for the distal RA. The intima-media volume (IMV) increased from 53.56±10.85mm to 58.70±13.04mm (p=0.0022), whereas the lumen volume (LV) decreased from 146.87±40.53mm to 129.64±45.78mm (p=0.0018) and vessel volume (VV) decreased from 201.23±44.55mm to 188.34±52.25mm (p=0.0306). Multiple regression analysis revealed diabetes as the most powerful independent predictor of the percentage change in IMV of the distal RA after TRI. The percentage change in IMV significantly increased in the DM group compared with non-DM group (p<0.001). The percentage change in IMV was significantly positively correlated with HbA1c.

CONCLUSIONS

Serial IVUS of the distal RA revealed a significant increase in IMV and decreases in LV and VV. Diabetes was the most powerful independent predictor of the percentage change in IMV of the distal RA after TRI. The percentage change in IMV was significantly positively correlated with HbA1c.

摘要

背景

经桡动脉介入治疗(TRI)可能会损伤桡动脉(RA)。我们已经通过血管内超声(IVUS)证实了 TRI 后远端 RA 的内膜-中层增厚和管腔狭窄。本研究旨在使用连续 IVUS 确定同一患者 TRI 后 RA 内膜-中层增厚的预测因素。

方法和结果

我们纳入了 110 例连续接受 TRI 的患者。TRI 后立即对 RA 进行 IVUS 检查,并在 6 个月后重复检查。对远端 RA 进行容积分析。内膜-中层体积(IMV)从 53.56±10.85mm 增加到 58.70±13.04mm(p=0.0022),而管腔体积(LV)从 146.87±40.53mm 减少到 129.64±45.78mm(p=0.0018),血管体积(VV)从 201.23±44.55mm 减少到 188.34±52.25mm(p=0.0306)。多元回归分析显示糖尿病是 TRI 后远端 RA 的 IMV 百分比变化的最有力独立预测因素。与非 DM 组相比,DM 组的 IMV 百分比变化明显增加(p<0.001)。IMV 的百分比变化与 HbA1c 呈显著正相关。

结论

连续的远端 RA IVUS 显示 IMV 显著增加,LV 和 VV 减少。糖尿病是 TRI 后远端 RA 的 IMV 百分比变化的最有力独立预测因素。IMV 的百分比变化与 HbA1c 呈显著正相关。

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