无症状下肢动脉病变老人的踝臂指数的检测及下肢动脉病变相关因素的分析  

Detection of ABI in aged patients with asymptomatic lower extremity arterial disease and analysis of lower extremity arterial disease correlative factors

作　　者：沈丹[1] 曹萍[1] 王桦[1] 刘珍丽[1] 

机构地区：[1]武汉大学中南医院综合医疗科,湖北武汉430071

出　　处：《心血管康复医学杂志》2012年第4期367-370,共4页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:检测无症状下肢动脉病变(LEAD)老人的踝臂指数(ABI),分析LEAD的相关因素。方法:随机选择206例老年患者,以ABI≤0.9作为LEAD的诊断标准,所有对象被分为无症状下肢动脉病变组(LEAD组,48例)和无下肢动脉病变组(无LEAD对照组,158例),比较两组心血管病危险因素的分布,分析与LEAD相关的因素。结果:LEAD组的年龄、动脉收缩压(SBP)、脉压(PP)、脂蛋白(a)[Lp(a)]、血尿酸(UA)、C反应蛋白(CRP)、糖化血红蛋白(HbA1c),以及臂踝脉搏波传导速度(baPWV)均明显高于无LEAD对照组(P<0.05,或P<0.01);而舒张压(DBP)显著低于无LEAD对照组(P<0.05)。Pearson相关分析显示,ABI与年龄(r=-0.347,P=0.025),PP(r=-0.246,P=0.034),Lp(a)(r=-0.321,P=0.002),UA(r=-0.215,P=0.046),CRP(r=-0.335,P=0.031),HbA1c(r=-0.272,P=0.017),baPWV(r=-0.278,P=0.017)均呈负相关。Logistic多元回归提示,年龄、SBP、PP以及Lp(a)与LEAD独立相关。结论:年龄、收缩压、脉压以及脂蛋白(a)是LEAD独立危险因素,其积极矫正有助于无症状下肢动脉病变的防治,减少心、脑血管事件的发生。Objective：To detect ankle brachial index（ABI）in aged patients with asymptomatic lower extremity arterial disease（LEAD）and analyze LEAD correlative factors.Methods：With ankle brachial index（ABI） ≤0.9 as diagnostic standard of LEAD,a total of 206 aged patients were randomly divided into asymptomatic LEAD group（LEAD group,n=48） and non-LEAD group（non-LEAD control group,n=158）.Distribution of cardiovascular risk factors was compared between two groups.Results： Compared with non-LEAD control group,there were significant increase in age,systolic blood pressure（SBP）,pulse pressure（PP）,lipoprotein（a） ,serum uric acid（UA）,C reactive protein（CRP）,glycosylated hemoglobin（HbA1c） and brachial-ankle pulse wave velocity（baPWV）,and significant decrease in diastolic blood pressure（DBP） in LEAD group（P0.05 or P0.01）.Pearson correlation analysis indicated that ABI was negatively correlated with age（r=-0.347,P=0.025）,PP（r=-0.246,P=0.034）,Lp（a）（r=-0.321,P=0.002）,UA（r=-0.215,P=0.046）,CRP（r=-0.335,P=0.031）,HbA1c（r=-0.272,P=0.017） and baPWV（r=-0.278,P=0.017）.Logistic multiple regression analysis indicated that age,SBP,PP and Lp（a） were independently correlated with LEAD.Conclusion：Age,systolic blood pressure,pulse pressure and lipoprotein（a） are independent risk factor of LEAD in aged patients,and correction of these risk factors may help to prevent and treat LEAD and reduce incidence of cardio-cerebrovascular events.

关 键 词：外周血管疾病 危险因素 踝臂指数 

分 类 号：R541.75[医药卫生—心血管疾病]