CAJ | 학술논문

目的：通过与标准冠状动脉造影比较，评估双轴旋转冠状动脉造影（XperSwing）在我国老年冠心病诊断中的临床安全性与可行性。方法2011年4月-2012年12月连续入选151例行诊断性冠状动脉造影、年龄≥65岁的患者，随机分为标准造影组（n=75）和XperSwing组（n =76），并记录两组患者造影所用对比剂用量、射线剂量及操作时间。记录术中症状、心律失常发生以及造影前后即刻血压、心率、血清肌酐值的变化。两组所需追加造影体位数用于比较两种方法的有效性。结果两组患者均顺利完成冠状动脉造影，并且追加造影体位数差异无统计学意义（P>0.05）。 XperSwing组总对比剂用量较标准造影组减少约44%[（29.28±5.06）ml 比（52.02±12.05）ml，P <0.01）]，总射线剂量减少约50%[（11383.60±4114.52）mGycm2比（22755.97±11239.22）mGycm2，P<0.01）]。两组造影所用操作时间、术中症状、心律失常发生以及造影前后即刻血压、心率、变化的差值均差异无统计学意义（P>0.05）。虽然两组间造影前后血清肌酐变化有统计学意义（P<0.05），但两组均未发生对比剂肾病。结论本研究显示XperSwing在中国老年人群冠心病诊断的临床使用中安全有效，相对标准造影来说，XperSwing能明显减少患者对比剂用量和射线剂量。
목적：통과여표준관상동맥조영비교，평고쌍축선전관상동맥조영（XperSwing）재아국노년관심병진단중적림상안전성여가행성。방법2011년4월-2012년12월련속입선151례행진단성관상동맥조영、년령≥65세적환자，수궤분위표준조영조（n=75）화XperSwing조（n =76），병기록량조환자조영소용대비제용량、사선제량급조작시간。기록술중증상、심률실상발생이급조영전후즉각혈압、심솔、혈청기항치적변화。량조소수추가조영체위수용우비교량충방법적유효성。결과량조환자균순리완성관상동맥조영，병차추가조영체위수차이무통계학의의（P>0.05）。 XperSwing조총대비제용량교표준조영조감소약44%[（29.28±5.06）ml 비（52.02±12.05）ml，P <0.01）]，총사선제량감소약50%[（11383.60±4114.52）mGycm2비（22755.97±11239.22）mGycm2，P<0.01）]。량조조영소용조작시간、술중증상、심률실상발생이급조영전후즉각혈압、심솔、변화적차치균차이무통계학의의（P>0.05）。수연량조간조영전후혈청기항변화유통계학의의（P<0.05），단량조균미발생대비제신병。결론본연구현시XperSwing재중국노년인군관심병진단적림상사용중안전유효，상대표준조영래설，XperSwing능명현감소환자대비제용량화사선제량。
Objective To evaluate the clinical safety and feasibility of dual-axis rotational coronary angiography (XperSwing) in diagnosing coronary artery disease in aged Chinese patients through comparing it with standard coronary angiography. Methods During the period from April 2011 to December 2012, a total of consecutive 151 patients with an age ≥ 65 years underwent diagnostic coronary angiography at authors’ hospital. The patients were randomly divided into the standard angiography group (n = 75) and XperSwing group (n = 76). The used dose of contrast, radiation exposure dose and operation time of each patient were recorded. Besides, the occurrence of procedure-related symptoms and arrhythmia during the procedure was recorded, and the blood pressure (BP), heart rate (HR) and creatinine level immediately before-and-after the procedure were estimated. The number of additional acquisition needed to be performed was used to evaluate the efficacy of the two methods. Results Coronary angiography was successfully accomplished in all patients of the two groups, and no significant difference in the number of additional acquisition existed between the two groups (P > 0.05). The used dose of contrast in XperSwing group was reduced by 44% when compared with that in the standard angiography group, i.e. (29.28 ± 5.06) ml vs(22 755.97 ± 11 239.22) mGycm2, (P<0.001). No statistically significant differences in the occurrence of procedure-related symptoms and arrhythmia during the procedure, in the operation time as well as in the postoperative changes of BP and HR existed between the two groups (P > 0.05). No contrast- induced nephropathy occurred in both groups, although the difference in postoperative changes of creatinine level between the two groups was statistically significant (P < 0.05). Conclusion This study indicates that in diagnosing coronary artery disease in aged Chinese patients, dual-axis rotational coronary angiography is more safe and effective than conventional coronary angiography, as XperSwing can significantly reduce the contrast dose and radiation exposure for the patients.