海南热带地区下肢动脉粥样硬化性疾病的患病特征研究  

Study on the prevalence characteristics of lower extremity atherosclerotic diseases in tropical regionofHainan

作　　者：李振振[1] 刘敏[2] 钱昊 戚悠飞[1] 肖占祥[1] 刘震东 许语阳 Li Zhenzhen;Liu Min;Qian Hao;Qi Youfei;Xiao Zhanxiang;Liu Zhendong;Xu Yuyang(Department of Vascular Surgery,Hainan Hospital Affiliated to Hainan Medical College,Hainan Provincial People's Hospital,Haikou 570311,China;Health Center,Hainan Provincial People's Hospital Hainan Medical College Affiliated Hainan Hospital,Haikou 570311,China)

机构地区：[1]海南省人民医院海南医学院附属海南医院血管外科,海口570311 [2]海南省人民医院海南医学院附属海南医院保健中心,海口570311

出　　处：《中华血管外科杂志》2024年第1期44-50,共7页Chinese Journal of Vascular Surgery

基　　金：海南省自然科学基金项目(820MS135);海南省卫生健康委员会2023年度省级临床重点学科(临床医学中心)建设单位基金项目(琼卫医函[2022]341号);海南省卫生健康科技创新联合项目(SQ2023WSJK0140)。

摘　　要：目的分析海南地区本地居民下肢动脉粥样硬化性疾病的患病特征。方法本文为回顾性队列研究。回顾性分析2013年8月至2023年4月海南省人民医院血管外科收治的626例海南本地下肢动脉硬化闭塞症(ASO)患者的临床资料。根据年龄、临床分级(Rutherford分级)及影像学分型(TASCⅡ分型)进行分组,比较组间一般资料、实验室检查及疗效的差异。结果626例患者中,男性占比(χ^(2)=62.449,P<0.001)、吸烟率(χ^(2)=39.979,P<0.001)、糖尿病患病率(χ^(2)=30.575,P<0.001)、空腹血糖(F=10.674,P<0.001)及甘油三酯(F=12.612,P<0.001)随着年龄的降低而升高,而女性占比(χ^(2)=62.449,P<0.001)、收缩压(F=3.579,P=0.028)、高血压患病率(χ^(2)=15.401,P<0.001)随着年龄的增大而升高。Rutherford4~6级[即严重下肢缺血(CLI)]占89.94%(563/626),Rutherford4~6级组踝肱指数(ABI)低于Rutherford1~3级组(0.36±0.22比0.48±0.20,t=4.275,P<0.001);TASCⅡC~D型占70.61%(442/626),TASCⅡC~D型组ABI低于TASCIA~B型组(0.32±0.21比0.48±0.22,t=8.247,P<0.001);且随着年龄的增长,Rutherford4~6级占比增大,治疗有效率降低,差异均有统计学意义(χ^(2)=12.283,P=0.002;χ^(2)=6.261,P=0.043)。TASCⅡ C~D组中CLI患者占比更高(92.53%比83.70%,χ^(2)=11.212,P=0.001),CLI组中TASCⅡC~D型占比更高(72.65%比52.38%,χ^(2)=11.212,P=0.001),差异具有统计学意义。结论海南本地ASO患者的病变以TASCⅡC~D型和Rutherford4~6级为主,年龄越大,分级越高。吸烟、男性、高血糖、高血脂等可能是ASO患病年轻化的危险因素。ObjectiveTo analyze the prevalence characteristics of patients with lower extremity atherosclerotic disease in the tropical region of Hainan.Methods The clinical data of 626 local patients of Hainan with lower limb arteriosclerosis obliterans(ASO)admitted to the Vascular Surgery Department of Hainan General Hospital from August 2013 to April 2023 were retrospectively analyzed,including age,gender,smoking rate,body mass index(BMI),ankle-brachial index(ABI),systolic blood pressure(SBP),diastolic blood pressure(DBP),serum uric acid(SUA),fasting blood glucose(FBG),total cholesterol(TC),triglycerides(TG),low-density lipoprotein(LDL),homocysteine(HCY),clinical grading(Rutherford classification),imaging classification(TASC Ⅱ classification),therapeutic effect.All the AsO patients were grouped by age,Rutherford classification and imaging classification(TASC II classification)to compare the general between-group data and data of serology,and examine the variations of treatment efficacy among the groups.Results Among all the patients,the proportion of males(χ^(2)=62.449,P<0.001),smoking rate(χ^(2)=39.979,P<0.001),the prevalence of diabetes(=30.575,P<0.001),FBG(F=10.674,P<0.001)and TG(F=12.612,P<0.001)increased with decreasing age.Conversely,the proportion of females(χ^(2)=62.449,P<0.001),SBP(F=3.579,P=0.028),and the prevalence of hypertension(χ^(2)=15.401,P<0.001)rose with increasing age.Among the 626 patients,the Rutherford 4-6 grade[that is critical limb ischemia(CLI)]group accounted for 89.94%(563 cases)and its ABI was lower than the Rutherford 1-3 grade group(0.36±0.22 vs.0.48±0.20,t=4.275,P<0.001);the TASC Ⅱ C-D group accounted for 70.61%(442 cases),and its ABI was lower than the TASC Ⅱ A-B group(t=8.247,P<0.001).Moreover,the proportion of the Rutherford 4-6 grade group and TASC Ⅱ C-D group increased with age,and the therapeutic effect also became worse,the differences were all statistically significant(χ^(2)=12.283,P=0.002;χ^(2)=6.261,P=0.043).In TASC ⅡC~D group,there was a higher proportion of pati

关 键 词：下肢动脉硬化闭塞症 热带地区 患病特征 踝肱指数 

分 类 号：R543.5[医药卫生—心血管疾病]