踝臂指数评价血液透析患者下肢外周动脉病多中心临床研究

目的通过测量踝臂指数(Ankle-brachial index, ABI)评价我国慢性肾功能不全(chronic renal failure, CRF)血液透析(hemodialysis, HD)患者下肢外周动脉病(peripheral arterial disease, PAD)的患病情况.方法对连续入选的271例行HD的CRF患者进行踝臂指数测定,并进行资料收集和统计学处理.结果 271例患者中61例合并下肢外周动脉病(平均ABI 0.62),其中只有4例(6.6%)患者得到了明确的诊断.PAD组与非PAD组患者相比,年龄(P=0.000)、糖尿病史(P=0.000)、血脂异常史(P=0.000)、吸烟量(P=0.002)和血肌酐水平(P=0.000)有统计学意义,而吸烟史(P=0.087)、高血压病史(P=0.053)无统计学意义.结论血液透析患者容易合并下肢PAD,ABI筛查下肢PAD简便易行;血液透析患者合并下肢PAD多见于高龄、糖尿病、血脂异常患者和大量吸烟患者.

A Multi-center clinical study of evaluation of lower extremity peripheral arterial disease in hemodialysis patients with chronic renal failure by measuring the ankle-brachial index

Objective To access the prevalence of lower extremity peripheral arterial disease (PAD) in hemodialysis patients with chronic renal failure (CRF) by measuring the ankle-brachial index (ABI). Methods A total of 271 hemodialysis patients with CRF (137 men and 134 women) were consecutively recruited. Data regarding cardiovascular risk factors, history of previous PAD, physical examination and ABI were collected and analyzed. Results By measuring the ABI, 61 patients (29 men) were found to have PAD (mean ABI 0.62). Of these patients, only 4 (6.6%) had previous documented PAD. There were significant differences in statistics between PAD and non-PAD group in age (P= 0.000), diabetes mellitus (P=0.000), dyslipidemia (P=0.000), pack-years of tobacco use (P=0.002) and serum creatinine level (P=0.000). However, there were no significant differences in smoking history (P=0.087), hypertension (P=0.053). Conclusion Hemodialysis patients with CRF are likely to have concomitant PAD. Measuring the ABI is a useful and simple method for identifying patients with PAD. PAD in hemodialysis patients with CRF is more popular in advanced age, diabetes mellitus, dyslipidemia patients or heavy smokers.