高血压患者趾臂指数、肱踝脉搏波传导速度及踝臂指数在下肢动脉疾病诊断中的临床价值  

Clinical value of toe-brachial index,brachial-ankle pulse wave velocity and ankle-brachial index for the diagnosis of lower extremity arterial disease in the patients with hypertension

作　　者：李静[1] 蔡静波[1] 王岚[1] 丁林锋[1] 王屹[1] 郭红梅[1] 

机构地区：[1]江苏省省级机关医院心内科,江苏省南京市210024

出　　处：《实用老年医学》2015年第5期380-383,共4页Practical Geriatrics

摘　　要：目的探讨高血压(HBP)患者趾臂指数(TBI)、肱-踝脉搏波传导速度(ba PWV)、踝臂指数(ABI)在下肢动脉疾病(LEAD)检测中的应用。方法将73例HBP患者根据下肢动脉内中膜厚度(IMT)分为2组:正常组41例,IMT≤1 mm;病变组32例,IMT>1 mm。分别测定2组患者的身高、体质量、血脂、ba PWV、ABI、TBI及下肢动脉超声。结果病变组年龄大于正常组(P<0.01)。与正常组比较,病变组ba PWV增快(P<0.01),TBI下降(P<0.01)。相关分析显示ABI与TBI正相关(P<0.01),ba PWV与年龄正相关(P<0.01)。ROC曲线显示当HBP患者ba PWV>1686.75 cm/s或TBI<0.725时,就有可能伴有LEAD。结论 HBP患者ABI正常时仍应进一步行TBI检测进一步明确有无LEAD。ba PWV>1686.75 cm/s或TBI<0.725的HBP患者可能伴有LEAD。Objective To explore the value of toe-brachial index（TBI）,brachial-ankle pulse wave velocity（ba PWV） and ankle-brachial index（ ABI） for the diagnosis of lower extremity arterial disease（ LEAD） in the patients with hypertension（ HBP）. Methods Seventy-three patients with HBP were divided into 2 groups according to the measurement of intima-media thickness（ IMT） in lower extremity artery： normal group（ n = 41） with IMT ≤1 mm and diseased group with IMT 1 mm. Height and weight were recorded. The levels of TBI,ba PWV and ABI were assessed by an automatic oscillometric method. The levels of TG,TC,HDL-C and LDL-C were examined at the same time. Results The age was higher（ P〈0. 01） and the level of TG was lower（ P〈0. 05） in disease group than that in normal group. The level of ba PWV was higher（ P〈0. 01） and TBI was lower（ P〈0. 01） in disease group than those in normal group. Correlation analysis revealed that ABI was positively correlated with TBI（ P〈0. 01）,and ba PWV was positively correlated with age（ P〈0. 01）. Conclusions The patients with HBP should receive the measurement of TBI to identify LEAD even ABI is in normal range. The patients with HBP may suffer from LEAD when the level of ba PWV is higher than 1686. 75 cm / s or TBI is lower than 0. 725.

关 键 词：趾臂指数 肱踝脉搏波传导速度 踝臂指数 下肢动脉疾病 高血压 

分 类 号：R544.1[医药卫生—心血管疾病]