老年缺血性卒中患者踝臂指数与颈动脉粥样硬化性狭窄的相关性  

Correlation between ankle-brachial index and carotid atherosclerotic stenosis in geriatric patients with ischemic stroke

作　　者：刘和锦[1] 王青[1] 李玉梅[1] 李雪迎[2] 

机构地区：[1]首都医科大学附属复兴医院干保科,北京100038 [2]北京大学第一医院医学统计室

出　　处：《中国脑血管病杂志》2010年第10期533-536,共4页Chinese Journal of Cerebrovascular Diseases

摘　　要：目的观察老年缺血性卒中患者踝臂指数(ABI)与颈动脉粥样硬化性狭窄(CAS)的相关性。方法选择190例老年缺血性卒中患者,收集相关危险因素和实验室检查资料,行ABI测量(ABI≤0.9为异常)和颈动脉超声检查。通过颈动脉彩色多普勒超声检查,将患者分为非狭窄组(狭窄率<50%)和狭窄组(狭窄率≥50%)。结果①狭窄组和非狭窄组患者ABI异常率分别为59.1%(26/44)和29.5%(43/146);狭窄组ABI值为0.81±0.23,低于非狭窄组的0.99±0.18,差异有统计学意义(P<0.001);狭窄组的年龄、糖尿病的患病率明显高于非狭窄组(P=0.005,P<0.001)。②多因素Logistic回归分析显示,糖尿病(OR=4.206,95%CI:1.957～9.040)和ABI异常(OR=3.385,95%CI:1.630～7.031)是狭窄率≥50%的CAS的独立相关因素(P<0.001)。③相关分析显示,ABI与颈动脉内膜-中层厚度(r=-0.320)和CAS程度(r_s=-0.365)均呈负相关(P<0.001)。结论老年缺血性卒中患者ABI降低与狭窄率≥50%的CAS独立相关,ABI值与颈动脉内膜-中层厚度和CAS程度均呈负相关。Objective To observe the correlation between the ankle-brachial index （ABI） and carotid atherosclerotic stenosis （CAS） in geriatric patients with ischemic stroke. Methods A total of 190 geriatric patients with ischemic stroke were selected. Their relevant risk factors and laboratory data were collected. The ABI measurements and carotid uhrasonography were performed. The patients were divided into either a non-stenosis group （stenosis 〈 50% ） or a stenosis group （stenosis ≥50% ） according to the examination by color Doppler ultrasonography. Results ①The prevalence of abnormal ABI in the stenosis group and non-stenosis group were 59.1% （26/44） and 29.5% （43/146） respectively. The ABI value （0.81 ±0.23） in the stenosis group was lower than 0.99 ±0.18 in the non-stenosis group. The difference was statistically significant （ P 〈 0. 001 ）. The age and prevalence of diabetes in the stenosis group were significantly higher than those in the non-stenosis group （P = 0. 005 ,P 〈 0.001 ）. ③The multivariate Logistic regression analysis showed that diabetes （ OR =4. 206, 95% CI： 1. 957 - 9. 040） and abnormal ABI （OR = 3. 385, 95% CI： 1. 630-7. 031 ） were the independent correlation faetors for CAS of ≥50% （P 〈0. 001 ）. ④The correlation analysis showed that ABI was negatively correlated with carotid intimamedia thickness （IMT） （r = -0. 320） and the severity of CAS （r, = -0. 365） （P 〈0. 001 ）. Conclusion The decreased ABI in geriatric patients with ischemic stroke is independently correlated to CAS of ≥50%, and the ABI value is negatively correlated with IMT and the severity of CAS.

关 键 词：脑缺血 卒中 老年人 动脉粥样硬化 颈动脉狭窄 踝臂指数 

分 类 号：R743.3[医药卫生—神经病学与精神病学]