踝臂指数与外周血管狭窄的相关研究  

Value of measuring ankle brachial index for diagnosing peripheral arterial disease in Chinese patients with high cardiovascular risk

作　　者：李觉[1] 胡大一[1] 庞文跃[2] 郭晓铭[1] 赵明中[1] 罗盈怡 乔永霞[1] 孙英贤[2] 

机构地区：[1]上海同济大学心肺血管中心,200092 [2]中国医科大学附属第二医院心内科 [3]上海医药高等专科学校

出　　处：《中华心血管病杂志》2008年第6期514-516,共3页Chinese Journal of Cardiology

摘　　要：目的与数字减影血管造影术（DSA）对比，评价踝臂指数（ABI）诊断外周动脉疾病的可靠性。方法连续选取在同济大学及中国医科大学两所附属医院心内科入院患者383例（男性245例，女性138例），所有患者都接受DSA检查及ABI的测量。结果研究对象中，他汀类药物干预率为90．9％、ACEI类为69．2％，抗血小板药为96．6％，B受体拮抗剂为67．9％。根据DSA将动脉狭窄分为正常、轻度狭窄（腔内狭窄〈30％）、中度狭窄（腔内狭窄30％～49％）、次重度狭窄（腔内狭窄50％～69％）、重度狭窄（腔内狭窄70％～89％）和完全闭塞（腔内狭窄≥90％）六个等级。与诊断外周动脉疾病的金标准DSA相比，随着下肢动脉狭窄程度加重，ABI值逐渐降低（ABI值分别为1．08±0．11．1．05±0．16．0．99±0．17，0．66±0．24，0．55±0．28和0．54±0．00）。结论ABI诊断外周动脉疾病与DSA比较有良好的相关性。Objective To evaluate the value of measuring ankle brachial index （ABI） for diagnosing peripheral arterial disease （ PAD ） compared with conventional digital subtraction angiography （DSA） as the reference standard. Methods A total of 383 consecutive inpatients （245 male, mean age 64. 1 ± 11.7 years） underwent both conventional DSA and ABI measurements. Results The rate of statin intervention was 90. 9%, ACEI 69. 2%, antiplatelet 96, 6% and β-blockers 67. 9%. The intravascular stenosis was classified into six degrees： normal, 〈30%, 30% -49%, 50% -69%, 70% -89% and ≥ 90%. Compared to the traditional gold standard （DSA） in diagnosis PDA, the ABI value decreased in proportion to the severity of PAD （ the ABI value was 1.08 ± 0. 11,1.05 ± 0. 16,0.99 ± 0. 17, 0. 66 ± 0. 24, 0. 55 ± 0. 28 and 0. 54 ± 0. 00 respectively in the six ranks）. There was a significant correlation between DSA and ABI in diagnosis PAD. Conclusion ABI measurement is an accurate and reliable non-invasive alternative to conventional DSA in the assessment of lower extremity arteries in patients with peripheral arterial disease.

关 键 词：外周血管疾病 血管造影术 数字减影 踝臂指数 

分 类 号：R686[医药卫生—骨科学]