踝肱指数用于诊断下肢动脉硬化闭塞症的临床意义

本文报告在１４４名患者的１８４侧肢体检测踝肱指数并与常规及超声血管造影结果进行前瞻性对比研究。按常规及超声血管造影两项检查一致结果将患者分为血管正常、狭窄及闭塞三组。正常组踝肱指数为１．０±０．０９（ｎ＝１６）；狭窄组为０．７±０．１７（ｎ＝８７）及闭塞组为０．４３±０．１４（ｎ＝８１）。各组间踝肱指数均有显著差异（Ｐ＜０．００１），Ｕ检验）。踝肱指数＜０．９５时，其诊断血管病变（狭窄与闭塞）的敏感性为９５％；特异性为７５％；阳性预期值为９７％；阴性预期值为６０％；准确性为９３％。将踝肱指数＜０．９５作为血管临界狭窄，＜０．５作为血管闭塞的判断标准，对临床上确定血管狭窄或闭塞具有一定的参考意义。     

ABI和PAI与绝经后女性骨质疏松症的相关性研究

目的探索踝肱指数(ABI)及血浆致动脉粥样硬化指数(PAI)与绝经后骨质疏松症之间的关系。方法选取2015年2月至2017年12月在我院病房及门诊就诊的绝经5年以上的402位女性患者,年龄45～65岁;记录和检测所有女性的绝经年龄、绝经时间、身高、体重、血脂、ABI、BMD和口服避孕药史。根据BMD在将患者分为2组,并比较两组患者的检测指标。结果共纳入96名绝经后骨质疏松症患者,平均年龄为(58.3±6.4)岁。对照组101例绝经后非骨质疏松症妇女,平均年龄(55.8±4.7)岁。三酰甘油水平比较差异无统计学意义;然而,在骨质疏松症组中,总胆固醇、低密度脂蛋白(LDL)和PAI及ABI水平较低,而高密度脂蛋白(HDL)水平较高,和对照组比较差异有统计学意义(P均0.05)。同时发现血清HDL、LDL、总胆固醇、PAI及ABI水平与股骨和腰椎BMD之间存在相关性。结论高水平HDL和低水平LDL,总胆固醇及PAI及ABI为绝经后女性骨质疏松症的危险因素。     

baPWV、ABI与不同数量动脉粥样硬化疾病及危险因素之间的相关性研究

目的了解同时罹患多种动脉粥样硬化疾病或危险因素时其肱-腘动脉脉搏波传导速度（baPWV）、胫后动脉与肱动脉收缩压的比值（ABI）与无危险因素组之间的关系,证明baPWV、ABI对动脉粥样硬化强度的早期预测价值。方法入选病例2033例,采集病史、年龄、血压、体重指数（BMI）、血糖（GU）、血浆总胆固醇（TC）、低密度脂蛋白胆固醇（LDL-C）、尿酸（UA）、左右baPWV（LbaPWV、RbaPWV）、左右ABI（LABI、RABI）等指标,根据动脉粥样硬化性疾病或危险因素的多少将病例进行分组。应用SPSS19.0统计软件包对比分析各观察组与对照组之间baPWV、ABI的差异。结果同时具有3个或3个以上、2个、1个动脉粥样硬化危险因素组,其baPWV与无危险因素组比较,均明显增高,P〈0.001,差异有统计学意义;ABI在不同组之间比较,部分差异显著、部分差异不显著,相关性较差。结论 baPWV与动脉粥样硬化危险因素的相关性良好,危险因素越多相关性越强,可作为一项独立预测因子,在早期识别普通人群动脉硬化程度、早期干预和早期诊断动脉血管硬化中具有明确的指导价值。ABI与危险因素的多少相关性较差。     

冠状动脉钙化病变特点及其与高血压PPI ABI的相关性

目的 探讨冠状动脉钙化病变特点及其与高血压动态脉压指数（PPI）及踝臂指数（ABI）的相关性。方法 将收治的疑似冠状动脉钙化患者220例,依照是否存在高血压将患者分为观察组及对照组;采用东芝Aquilion one 320排容积CT对患者行冠状动脉CTA检查,依照冠状动脉CT扫描检查结果及AHA分类标准对患者检查结果进行评估。结果 冠状动脉钙化病变除可见轻度或中度狭窄合并部分/点状钙化,重度狭窄合并血管钙化外,也可见轻度、中度、重度狭窄合并弥漫性/多发血管钙化;高血压组患者ABI评分结果与冠状动脉钙化评分（CACS）评分呈显著负相关关系（P＜0.05）,ABI评分与CACS无相关性（P＞0.05）;观察组患者PPI评分与CACS评分正性相关（P＜0.05）,但对照组患者PPI评分与CACS评分无显著相关关系（P＞0.05）。结论 冠状动脉钙化常合并血管狭窄,且其冠状动脉钙化程度与高血压患者PPI、ABI呈正性相关。     

Antithrombotic Therapy for Peripheral Artery Disease: Recent Advances

Peripheral artery disease (PAD) affects over 200 million people globally and is a cause of significant morbidity, mortality, and disability due to limb loss. Although secondary prevention with antithrombotic therapy is a mainstay of treatment to prevent adverse cardiovascular events, PAD patients are often undertreated with antithrombotic agents. Furthermore, there is a paucity of high-quality data from randomized controlled trials of PAD patients, leading to wide variations in clinical practice and guideline recommendations. Recently, there have been important advances that have further increased the number of antiplatelet and anticoagulant choices potentially available for patients with PAD. In this context, this paper aims to summarize the current available evidence for the safety and efficacy of various antithrombotic agents in PAD, and discuss how to integrate this emerging evidence into actual clinical practice. An evidenced-based approach to PAD patients is essential to achieve optimal outcomes, weighing cardiovascular and limb benefits against bleeding risks.     

Automated Bedside Measurement of Penile Blood Flow Using Pulse-Volume Plethysmography

Purpose To evaluate the efficiency of the form PWV/ABI (pulse wave velocity/ankle brachial pressure index) for measuring penile blood pressure (PBP) and the penile brachial pressure index (PBI). Methods We measured PBP and the PBI using both form PWV/ABI and Doppler ultrasonography in 40 men with surgical disorders. Results By using pulse-volume recording, the form PWV/ABI can simultaneously measure PBP and bilateral brachial artery pressure, and calculate the PBI automatically. The data obtained showed strong correlations with those obtained by the conventional Doppler ultrasound technique. Moreover, measurements were completed within 5 min at the bedside and the data were stored in the device's memory. Conclusion The form PWV/ABI is a useful tool for assessing pelvic hemodynamics and diagnosing vasculogenic impotence.     

Long-Term Effectiveness of the Zilver PTX Drug-Eluting Stent for Femoropopliteal Peripheral Artery Disease in Patients with No Patent Tibial Runoff Vessels—Results from the Zilver PTX Japan Post-Market Surveillance Study

Purpose

To evaluate 2-year results of the Zilver PTX (Cook Medical, Bloomington, Indiana) drug-eluting stent (DES) for femoropopliteal peripheral artery disease (PAD) in patients with no continuous patent infrapopliteal runoff arteries compared with patients with ≥ 1 continuous patent runoff vessels.

成都某高校退休人群患动脉粥样硬化的特征性研究

目的以成都某高校退休教职工为研究对象,分析踝肱指数及臂踝脉搏波传导速度与各影响因素的相关性,研究该人群中患动脉粥样硬化及周围动脉硬化闭塞性疾病的特征性。方法研究对象选自成都某高校退休教职工体检人群,进行ABI值及Ba PWV值的测定,并收集其性别、年龄、体重、身高,吸烟状况以及有无高血压、糖尿病、血脂异常疾病史等信息,进行数据分析。结果研究对象的ABI值范围在0.85~1.68,平均值为(1.11±0.09),ABI值与年龄相关性较弱(r=0.224,P=0.001),与BMI值的相关性无统计学意义(r=-0.083,P=0.238)。ABI值在男女性别、有无吸烟史及有无高血压病史间差异有统计学意义(P<0.05)。Ba PWV值为1045~3791.5,平均值为(1781.23±410.82),与年龄显著相关(r=0.570,P=0.000),与BMI值的相关性无统计学意义(r=-0.079,P=0.262)。结论周围动脉硬化闭塞症与动脉粥样硬化的发生、发展与年龄、吸烟、高血压、糖尿病、血脂异常等危险因素密切相关,早期检测动脉硬化闭塞疾病指标,及早采取干预措施,对保护心脑血管、减少心血管事件的发生有着十分重要的作用。     

Prevalence of high ankle-brachial index (ABI) in general population of Southern Italy, risk factor profiles and systemic cardiovascular co-morbidity: An epidemiological study

Many studies have been carried out to assess the prevalence, risk factors and co-morbidities of peripheral artery disease (PAD). By contrast, to date there is a lack of data on patients with high-ABI. This study aimed at estimating the prevalence of increased ABI (ABI > 1.4) and to evaluate the involvement of traditional cardiovascular (CV) risk factors and the atherosclerotic burden (peripheral and carotid arteries) of these patients in a population of Southern Italy. We invited 9647 subjects, age ranging from 30 to 80, by letters to undergo an ABI measurement. Consequently, in patients with ABI > 1.4, an ultrasound evaluation of the peripheral and carotid arteries was performed. An ABI > 1.4 was found in 260 of 3412 subjects (7.6%). Statistically significant differences were reported in age, diabetes and hypertension, body mass index (BMI) and waist circumference (WC). No differences in sex distribution, dyslipidemia and smoke prevalence were observed. Moreover, 67.9% of ABI > 1.4 patients showed a peripheral intima-media thickness (IMT) > 0.9 mm; at linear regression it was correlated with ABI values; 25% of patients showed peripheral plaques. A carotid IMT > 0.9 mm was reported in 78.6% of high-ABI patients and 32.1% were affected by atherosclerotic plaques. The observed increased-ABI prevalence of 7.6% was higher than previously reported. This was more prevalent in an older population with diabetes, hypertension and obesity. Moreover, these patients are characterized by an extended atherosclerotic involvement. Further studies are needed to clarify this evidence, a longitudinal observation of this clinical outcome, as we are performing, could provide a number of interesting elements.