左右臂踝脉搏波传播速度绝对差值诊断外周动脉疾病的价值  

Absolute right-left brachial-ankle pulse wave velocity difference significance in diagnosis of peripheral arterial disease

作　　者：侯建明[1] 林庆明[1] 李建卫[2] 庄维特[1] 陈刚[1] 张超群[1] 林丽香[1] 

机构地区：[1]福建医科大学省立临床医学院,福建省立医院内分泌科,福州350001 [2]福建医科大学省立临床医学院,福建省立医院超声科,福州350001

出　　处：《中华临床医师杂志（电子版）》2007年第2期83-85,共3页Chinese Journal of Clinicians(Electronic Edition)

基　　金：福建省自然科学基金计划资助项目(C0410041)

摘　　要：目的探讨并发外周动脉疾病（PAD）的糖尿病患者下肢动脉臂踝脉搏波传播速度（baPWV）的改变情况。方法102例健康对照组和101例2型糖尿病患者（包括PAD患者）。用动脉硬化诊断仪测量baPWV和踝肱比值（ABI）。结果无并发PAD的糖尿病患者baPWV高于健康对照组（中位数1640与1110cm/s,P〈0.05）。并发PAD的糖尿病患者,患肢baPWV低于非患肢baPWV（中位数1300与1650cm/s,P〈0.05）。对于同年龄组患者（50-70岁）,并发PAD的糖尿病患者患肢baPWV（中位数1300与1640cm/s,P〈0.05）和ABI（中位数0.8与1.1,P〈0.05）均比无并发PAD的糖尿病患者低。并发PAD的糖尿病患者左右baPWV绝对差值均较无并发PAD者大（均P〈0.05）。并发PAD的糖尿病患者左右baPWV绝对差值与患肢ABI呈负相关（rs=-0.586,P〈0.05）。结论糖尿病患者baPWV增加,而并发PAD后患肢baPWV降低,左右baPWV绝对差值可能用于PAD的诊断。Objective The purpose of this study was to examine the alternation in brachial-ankle pulse wave velocity （baPWV） in lower-limb arteries among diabetic patients with peripheral arterial disease （PAD）. Methods One hundred and two healthy control subjects and 101 type 2 diabetic patients including those with PAD were admitted. Ankle-brachial index （ABI） and baPWV were also measured with Japanese VS-1000 arteriosclerosis diagnometer. Results Diabetic patients without PAD showed a higher baPWV than healthy control subjects （median 1 640 vs. 1 110 cm/s, P 〈 0. 05 ）. However, among diabetic patients with PAD,baPWV was lower in the affected legs than in the non-affected legs （ median 1 300 vs. 1 650 cm/s,P 〈 0. 05）. The PAD group showed reduction in both baPWV and ABI compared with the non-PAD group in the same age categories （median 1 300 vs. 1 640 cm/s;0. 8 vs. 1.1 ,P 〈0. 05）. The absolute right-left difference in baPWV for diabetic patients with PAD was higher than the non-PAD subjects （ P 〈 0. 05 ）. In diabetic patients with PAD, the absolute right-left difference in baPWV showed an inverse correlation with ABI （rs = -0. 586 ,P 〈 0. 05）. Conclusions The baPWV is increased in diabetic patients, whereas it is decreased in the affected legs in diabetic patients with PAD. The absolute right-left difference in baPWV may diagnose PAD.

关 键 词：血管疾病 外周 糖尿病 2型 脉搏波传播速仪 踝肱指数 

分 类 号：R543.5[医药卫生—心血管疾病]