踝肱动脉指数、彩色多普勒超声和数字减影血管造影评估糖尿病外周血管病变的比较  

Comparison of Ankle Brachial Artery Index,Color Doppler Ultrasound and Digital Subtraction Angiography in Evaluating Diabetic Peripheral Vascular Disease

作　　者：王友杰[1] 程清涛 WANG Youjie;CHENG Qingtao(Deyang People’s Hospital,Sichuan 618000,China)

机构地区：[1]四川省德阳市人民医院,四川618000

出　　处：《影像科学与光化学》2025年第2期140-146,共7页Imaging Science and Photochemistry

摘　　要：目的:对比分析踝肱动脉指数(ABI)、彩色多普勒超声和数字减影血管造影(DSA)评估糖尿病外周血管病变的效果。方法:选取2018年1月至2020年1月本院收治的120例疑似糖尿病外周血管病变患者作为研究对象,所有患者均在入院后实施ABI、彩色多普勒超声、DSA及综合检查(病例病史+实验室检查+组织病理检查),并以综合检查结果为“金标准”,对比ABI、彩色多普勒超声和DSA评估糖尿病外周血管病变的价值。结果:经综合检查确诊,120例疑似患者中明确为糖尿病外周血管病变者90例,占75.00%。经Kappa一致性检验,ABI、彩色多普勒超声和DSA诊断糖尿病外周血管病变结果与综合检查结果的一致性分别为0.649、0.708、0.994。绘制ROC曲线图发现,ABI、彩色多普勒超声和DSA诊断糖尿病外周血管病变的AUC分别为0.850、0.878、0.994。将综合检查结果作为金标准,DSA诊断糖尿病外周血管病变的灵敏度、特异度、准确度、阳性及阴性预测值均高于ABI、彩色多普勒超声检查(P<0.05),而ABI、彩色多普勒超声诊断糖尿病外周血管病变的灵敏度、特异度、准确度、阳性预测值、阴性预测值相比,差异不显著(P>0.05)。结论:ABI、彩色多普勒超声和DSA诊断糖尿病外周血管病变均有一定价值,但DSA诊断糖尿病外周血管病变与综合检查结果的一致性更好,诊断的灵敏度、特异度、准确度更高。Objective:To compare and analyze the effect of ankle brachial artery index(ABI),color Doppler ultrasound and digital subtraction angiography(DSA)in evaluating diabetic peripheral vascular disease.Methods:120 patients with suspected diabetic peripheral vascular disease admitted to our hospital from January 2018 to January 2020 were selected as the research objects.All patients underwent ABI,color Doppler ultrasound,DSA and comprehensive examination(case history+laboratory examination+histopathological examination)after admission.The value of ABI,color Doppler ultrasound and DSA in evaluating diabetic peripheral vascular disease was compared with the results of comprehensive examination as the“gold standard”.Results:After comprehensive examination,90 of 120 suspected patients were diagnosed as diabetic peripheral vascular disease,accounting for 75.00%.After Kappa’s consistency test,the consistency of ABI,color Doppler ultrasound,and DSA in the diagnosis of diabetes peripheral vascular disease and the results of comprehensive examination was found to be 0.649,0.708,and 0.994,respectively.The AUC of color Doppler ultrasound,DSA,and ABI in the diagnosis of diabetic peripheral vascular disease were 0.850,0.878,and 0.994,respectively,according to the ROC curve.When using the comprehensive examination findings as the gold standard,DSA was found to have greater sensitivity,specificity,accuracy,positive predictive value,and negative predictive value(P<0.05)than both ABI and color Doppler ultrasound in the diagnosis of diabetic peripheral vascular disease.ABI and color Doppler ultrasound did not substantially vary(P>0.05)in their sensitivity,specificity,accuracy,positive predictive value,or negative predictive value in the diagnosis of diabetic peripheral vascular disease.Conclusion:ABI,color Doppler ultrasound and DSA have certain value in the diagnosis of diabetic peripheral vascular disease,but DSA has better consistency with comprehensive examination results in the diagnosis of diabetic peripheral vascular disease

关 键 词：糖尿病外周血管病变 踝肱动脉指数 彩色多普勒超声 数字减影血管造影 诊断价值 

分 类 号：R587.2[医药卫生—内分泌]