主-髂动脉闭塞后CTA显示的侧支循环对踝肱指数影响的初步研究

目的探讨主-髂动脉闭塞后CTA显示的侧支循环对踝肱指数(ABI)的影响。资料与方法回顾性分析主-髂动脉闭塞且CTA显示侧支循环的病例18例(A组);主-髂动脉闭塞,CTA未显示侧支血管的病例18例(B组);主-髂动脉轻度狭窄的病例24例(C组)。对照各组的ABI值,并对三组样本的ABI均数进行统计学分析。结果 A组,右侧ABI均值为0.44±0.18;左侧ABI均值为0.41±0.16。B组,右侧ABI均值为0.40±0.09;左侧ABI均值为0.41±0.11。C组,右侧ABI均值0.73±0.22;左侧ABI均值为0.71±0.19。各组右侧与左侧之间ABI的差别均无统计学意义,P>0.05;右侧A、B、C三组的差异有统计学意义,P<0.001。组间两两比较,主-髂动脉闭塞后CTA显示了侧支循环的A组与CTA未显示侧支循环的B组之间ABI值无统计学差异,P>0.05;A组与C组及B组与C组之间的差别均有统计学意义,P<0.05。左侧组内及组间差异与右侧一致。结论主-髂动脉闭塞后CTA所能显示的侧支循环尚未对ABI数值产生影响。CTA及ABI作为形态学和功能学检查方法,在判定下肢缺血程度、制定合理的治疗方案时应综合运用。

The Study on the Influence of the Collateral Circulation of Aorto Iliac Occlusive Disease on Ankle Brachial Index in CTA

Objective To evaluate the influence of the collateral circulation of aorto iliac occlusive disease on ankle brachial index in CT angiography.Materials and MethodsPatients with aorto iliac occlusive disease were analyzed retrospectively.In group A,there were 18 patients whose CTA showed collateral circulation in aorto iliac occlusive disease.In group B,there were 18 patients whose CTA did not show collateral circulation in aorto iliac occlusive disease and 24 patients whose CTA showed mild stenosis in group C.The ABI among three groups were compared,and the statistical analysis of sample mean were conducted.ResultsThe mean value of right ABI was(0.44±0.18) for group A,and the left was(0.41±0.16),respectively.The mean value of right and left ABI were(0.40±0.09) and(0.41±0.11) for group B;(0.73±0.22) and(0.71±0.19) for group C.There was not significant difference between the left and the right ABI in all the three groups(P>0.05).Between these three groups,there was not significant difference between group A and B(P>0.05),but significant difference was found between group A and C,group B and C(P<0.05),respectively.ConclusionIn aorto iliac occlusive disease,the collateral circulation on CTA do not affect ankle brachial index(ABI).CTA performance and ABI can provide morphology and function information for vascular surgery,combination of these factors will be more helpful for diagnosis and treatment planning.