指端收缩压在振动性血管损伤诊断中应用  

Application of finger systolic blood pressure in the diagnosis of vibration-induced vascular injury

作　　者：肖斌[1] 温薇[1] 陈青松 严茂胜[1] 林瀚生 张丹英[1] 徐国勇[1] XIAO Bin;WEN Wei;CHEN Qing-song;YAN Mao-sheng;LIN Han-sheng;ZHANG Dan-ying;XU Guo-yong(Gungdong Prorince Hospital for Occupational Disease Prevention and Trealmen,Guangdong 510300,China;Guangdong Prorincial Key Laboratory of Occupoational Disease Prerention and Treutmen1,Gilpngzhou,Guangdong 510300,China)

机构地区：[1]广东省职业病防治院广东省职业病防治重点实验室,广东广州510300 [2]广东药科大学公共卫生学院,广东广州510315

出　　处：《中国职业医学》2021年第4期392-396,共5页China Occupational Medicine

基　　金：广东省自然科学基金(2018A030313955);广东省医学科学技术研究基金(A2019177,A2019388);广东省职业病防治重点实验室(2017B030314152);广州市科技计划项目(201804010099);海珠区科技计划项目(海科工商信计2018-90)。

摘　　要：目的研究指端收缩压(FSBP)在振动性血管损伤诊断中的应用价值。方法采用非随机同期对照试验,选择30名有振动性白指(VWF)的振动性血管损伤患者为病例组,以30名无VWF的手传振动作业工人为对照组。对2组人群受测手进行FSBP测量,比较各手指的FSBP指数(F;)。结果病例组人群受测手食指、中指、无名指和小指的F;分别低于对照组相同手指(P值均<0.01)。病例组人群受测手食指F;分别低于其无名指和小指(P值均<0.01)。病例组人群受测手食指、中指和无名指F;异常率分别高于对照组相同手指(86.7%vs 10.0%,76.7%vs 13.3%,43.3%vs 10.0%,P值均<0.01)。研究对象受测手食指、中指、无名指、小指F;的受试者工作特征曲线下面积分别为0.884、0.843、0.764和0.687;食指F;的诊断截断值为80.2%,灵敏度、特异度分别为86.7%和90.0%。结论 FSBP测量在振动性血管损伤诊断中具有较好的应用价值;建议首选食指F;作为诊断指标,其异常判定值可设定为80.0%。Objective To evaluate the application value of finger systolic blood pressure(FSBP) in the diagnosis of vibration-induced vascular injury. Methods Thirty patients with vibration-induced vascular injury [vibration-induced white finger(VWF)] were selected as the case group by a non-randomized concurrent controlled trial, and 30 hand-transmitted vibration workers without VWF were selected as the control group. The FSBP test was performed on the tested hands of all subjects, and the FSBP index of each Finger(F;) was measured. Results The F;of the index finger, middle finger, ring finger and tail finger of the tested hand in the case group were lower than that in the control group(all P<0.01). In the case group, the F;of index finger was lower than ring finger and tail finger(all P<0.01). The abnormal rates of F;on the index, middle and ring fingers in the case group were higher than those in the control group(86.7% vs 10.0%, 76.7% vs 13.3%, 43.3% vs 10.0%, all P<0.01). The area under the receiver operator characteristic curve of the measured F;of the index finger, middle finger, ring finger and tail finger were 0.884, 0.843, 0.764 and 0.687 respectively. The diagnostic cut off value of the F;of index finger was 80.2%. The sensitivity and specificity were 86.7% and 90.0%, respectively. Conclusion FSBP test has a good application value in the diagnosis of vibration-induced vascular injuries. It is suggested that the F;of index finger be the first choice as the diagnostic index, and the abnormal value can be set at 80.0%.

关 键 词：指端收缩压 手传振动 振动性白指 诊断 受试者工作特征曲线 灵敏度 特异度 应用价值 

分 类 号：R135.4[医药卫生—劳动卫生]