急性下肢动脉缺血程度分级相关因素探讨  

Related factors of ischemic categories in acute lower extremities ischemia

作　　者：夏彩凤[1] 顾建平[1] 楼文胜[1] 何旭[1] 陈亮[1] 陈国平[1] 

机构地区：[1]南京医科大学附属南京第一医院介入科,江苏南京210006

出　　处：《生物医学工程与临床》2012年第5期430-433,共4页Biomedical Engineering and Clinical Medicine

基　　金：国家科技部"十一五"支撑计划课题项目(2007BAI05B04)

摘　　要：目的 探讨影响急性下肢动脉缺血分级的相关因素。方法 回顾性分析笔者2005年5月至2010年6月间收治的73例经造影证实为急性下肢动脉栓塞或急性下肢动脉血栓形成的患者，其中男性40例，女性33例，年龄35 - 90岁，平均年龄68.5岁。采集临床相关资料，对性别、年龄、缺血时间、吸烟史、其他合并症、肢体动脉栓塞史、梗阻原因（栓塞/血栓形成）等可能影响急性缺血分级的因素，使用SPSS 11.5软件进行多因素逻辑回归分析。结果 该组患者73例，79条患肢，急性缺血分级：Ⅰ级2例（3条患肢）；Ⅱ级65例，其中Ⅱa级32例（34条患肢），Ⅱb级33例（36条患肢）；Ⅲ级6例（6条患肢）。缺血时间、糖尿病及梗阻性质可影响患者缺血程度（P 〈 0.05）。随着缺血时间的延长，缺血程度逐渐加重；糖尿病患者下肢缺血程度倾向于Ⅱa级以下；急性动脉血栓形成缺血程度倾向于Ⅱa级，急性动脉栓塞缺血程度更趋向于Ⅱb级。结论 缺血时间、糖尿病及梗阻性质与急性肢体缺血分级有相关性。Objective To explore the factors related to the clinical categories of acute limb ischemia（ALI）. Methods A total of 73 patients with acute arterial embolism or acute arterial thrombosis of lower extremities were enrolled, male 40, female 33, aged 35 - 90 years old, mean age 68.5 years old, which were diagnosed by digital subtraction angiography（DSA） from May 2005 to June 2010. The suspected influence factors of ALI clinical data were collected and performed with muhivariate logistic regression analysis with SPSS 11.5 software as follows： sexual, age, isehemic time, history of smoking, other complications, pervious history of acute limb arterial embolism and occlusion causes（embolism/thrombosis）. Results A total of defected 79 limbs in 73 patients with ALI were involved in the present study, which included 3 of Class Ⅰ, 34 of Class Ⅱ a, 36 of Class Ⅱb and 6 of Class Ⅱ. The statistically significant influence factors of ALI clinical categories included ischemic time, diabetes mellitus and occlusion causes（P 〈 0.05）. The ischemic degree increased gradually with extension of ischemic time, and patients with diabetes mellitus tended to be below the stage of Class Ⅱ a. Additionally, patients with acute arterial embolism was more likely to be linked with Class Ⅱ b and higher stage, and acute arterial thrombosis more likely happened in the patients at Class Ⅱ a. Conclusion It is demonstrated that the clinical categories of ALI could be influenced by ischemic time, diabetes mellitus and occlusion causes.

关 键 词：急性肢体缺血 下肢 缺血分级 

分 类 号：R654.4[医药卫生—外科学]