基于四肢同步检测踝臂指数的方法和临床研究

目的利用优选法在波形特征法和幅度系数法的基础上提出1种同步采集四肢脉搏波信号和袖套压力波信号无创检测踝臂指数的新方法。方法计算出相邻脉搏波的幅度差值和它们的相对比值,并利用优选法在一定范围内进行突变点的判断。结果该方法能够解决将收缩压以前的点和平均压附近的点误判为突变点的问题,大量的病例分析和临床测试证实了该算法的有效性和可靠性。结论踝臂指数是动脉硬化的一个简便可靠的预测因素,它与传统的动脉硬化危险因素如年龄、血压等有相关性。     

颅内动脉狭窄与前后循环及相关危险因素关系研究

目的:比较颅内动脉狭窄与前后循环分布情况及相关危险因素,为采取针对性防治提供参考。方法:选择经超声和影像学检查存在单纯颅内动脉狭窄缺血性卒中198例,排除前循环合并后循环动脉狭窄42例,分为前循环动脉狭窄组(前循环组)124例和后循环动脉狭窄组(后循环组)32例,比较两组的危险因素,并进行多元Logistic回归分析。结果:前循环组动脉狭窄发生率非常显著高于后循环组(P<0.01);后循环组年龄显著大于前循环组(P<0.05);两组男女比例差异显著(P<0.05);前循环组总胆固醇(TC)水平显著高于后循环组(P<0.05)。经多元Logistic回归分析,糖尿病进入以前循环颅内动脉狭窄为因变量的回归方程(P<0.05);年龄和糖尿病进入以后循环颅内动脉狭窄为因变量的回归方程(P<0.05)。结论:颅内动脉狭窄中以前循环动脉狭窄较常见,前、后循环颅内动脉狭窄危险因素存在差异。     

脉搏波速和踝臂指数在冠心病及其危险因素检测中的临床应用进展

随着人们生活水平的提高，生活方式和习惯的改变，动脉硬化性疾病发病率逐年提高。冠心病是动脉粥样硬化发展引起器官损害的结果，是全身动脉硬化性疾病的一部分，对人类健康危害极大。早期发现动脉粥样硬化临床前期病变（preclinieal atherosclerosis，PCA）并进行及时有效的干预，是控制心血管疾病与事件的关键和根本措施。     

踝臂指数在糖尿病性血管病变中的诊断意义

踝臂指数(ankle-brachial index,ABI)作为一种无创且简单易行的检测方法,可较准确的评估糖尿病性下肢动脉病变、心脑血管病变的严重程度和预后判断。     

西宁地区踝臂指数检查对冠心病患者临床意义

目的:探讨踝臂指数(ABI)检查对冠心病患者的临床意义。方法:52例冠状动脉造影确诊冠心病患者和冠状动脉造影排除冠心病对照组50例进行ABI检查比较。临床资料分组、根据ABI检查结果,进行统计学分析。结果:冠心病患者ABI降低明显;ABI降低越明显,冠状动脉狭窄指数积分、多支血管病变发生率高。ABI检测与冠脉狭窄程度积分呈负相关(P<0.01)。结论:ABI检测可作为冠心病患者病情严重程度评估;ABI检测与冠状动脉病变严重程度呈显著相关性。     

踝臂指数与冠脉病变关系的研究

踝臂指数（Ankle—brachial index,ABI）常用于下肢外周动脉病（Perip heral arterial disease,PAD）的诊断,近年研究显示踝臂指数（ABI）降低对预测心血管事件的发生和死亡也具有很高的价值。本研究对进行选择性冠状动脉造影（Coronary arteriography,CAG）患者同时测量踝臂指数,探讨踝臂指数与冠状动脉病变程度的关系。     

高血压患者颅内动脉狭窄相关因素的横断面研究

目的探讨高血压患者颅内动脉狭窄的相关因素。方法选择原发性高血压患者208例，根据经颅多普勒超声诊断技术（TCD）测量结果分为颅内动脉狭窄组和非狭窄对照组，观察颈动脉狭窄的分布特征，同时采集患者流行病学资料，包括性别、年龄、身高、体重、血糖、血脂、烟酒嗜好、病程、家族史等。先进行单因素分析，对单因素分析P〈０．01的解释变量再纳入多因素Logistic回归分析。结果TCD共检测到45例（21．64％）颅内动脉狭窄；单因素分析显示：吸烟、高龄、病程长、血压较高、高TC、高TG患者更易发生颅内动脉狭窄；多因素分析显示：年龄、病程、收缩压、LHL—H纳入的回归方程有统计意义，P〈0．05。结论年龄、病程、收缩压、LHL—H是导致高血压患者颅内动脉狭窄的独立危险因素，其中年龄、病程为不可控因素，延缓颅内动脉狭窄的关键应是良好的血压控制和血脂改善。     

高血压患者危险因素及颅内动脉狭窄的多普勒观察

目的观察高血压患者颅内动脉狭窄经颅多普勒特点及其影响因素。方法选择180例住院和门诊高血压患者，排除合并中风、糖尿病及其他颅内疾病，用经颅多普勒超声诊断仪检查颅内动脉狭窄情况。结果39例患者有颅内动脉狭窄，患病率为21．66％。检查动脉血管1640条，狭窄动脉92条，总的动脉狭窄率为5．60％。大脑中动脉狭窄发病率最高，其次为颅内动脉虹吸段。颈内动脉狭窄率占总狭窄率的80％，明显高于椎一基动脉。老年高血压患者总狭窄率及单一狭窄高于非老年病人。狭窄组总胆固醇、甘油三脂、低密度脂蛋白、载脂蛋白B水平明显高于非狭窄病组。结论高血压颅内动脉狭窄最常发生于大脑中动脉及颅内动脉虹吸段，年龄、脂代谢紊乱是高血压病人发生颅内动脉狭窄的危险因素。     

踝臂指数与2型糖尿病及其大血管并发症关系的研究

目的分析2型糖尿病患者动脉病变与大血管并发症的关系。方法选取近两年在我科住院的152例2型糖尿病患者,其中无大血管并发症者70例,合并大血管并发症者82例,检测其动脉内中膜厚度（IMT）及斑块,踝臂指数（ABI）,并测定其血糖、血脂、尿酸及体重指数,比较各组间差异。结果①糖尿病合并大血管并发症组与无血管病发症组比较,年龄、糖尿病病程、吸烟比例、糖化血红蛋白、收缩压水平及HDL-C有差异。②合并大血管并发症组颈动脉IMT值显著增高,斑块发生率高,ABI异常率高。结论 2型糖尿病的大血管病变与多种因素相关,ABI与常见心血管病变危险因素存在聚集性。     

高海拔地区联合踝臂指数与彩超筛查糖尿病下肢血管病变的意义

目的：探讨青海西宁地区踝臂指数（ankle brachial index,ABI）联合彩超（CDFI）筛查糖尿病下肢血管病变的意义。方法：选取2012年12月—2014年2月在我院体检中心体检的西宁地区2型糖尿病人群150例和147例非糖尿病人群进行ABI检测,对ABI≤0.9、ABI≥1.3异常者同时进行双下肢血管彩超检查,并进行对照分析。结果：150例糖尿病组中ABI异常检出18例,占总数的12.00%,在147例非糖尿病组中ABI异常检出9例,占总数的6.12%,两组ABI异常检出率比较差异有统计学意义（P〈0.05）;ABI异常经下肢血管彩超证实有病变的糖尿病组7例（38.89%）,非糖尿病组1例（11.11%）,两组比较存在显著差异（P〈0.01）。结论：联合踝臂指数与下肢血管彩超在早期筛查糖尿病下肢血管病变中有重要的指导意义。     

利用IVUS-VH探讨踝臂指数升高的不稳定型心绞痛患者冠脉病变特点的研究

目的利用冠状动脉血管内超声及虚拟组织成像技术（IVUS．VH）探讨踝臂指数（ABI）升高的不稳定型心绞痛（uA）患者冠脉病变特点。方法137例uA患者依据ABI检查结果分为ABI正常组（0．9≤ABI≤1．4）及ABI升高组（ABI〉1．4）,所有患者行冠状动脉造影（CAG）、IVUS及ABI检查,分析患者冠脉病变特点。结果ABI升高组年龄、高血压、糖尿病患病率、吸烟比例、血肌酐、总胆固醇水平高于ABI正常组。病变血管分布及病变部位两组相比差异无统计学意义。IVUS—VH检查,斑块长度、钙化百分比ABI升高组高于ABI正常组;坏死核心百分比、易损斑块数、斑块破裂血栓、血管重构指数ABI升高组低于ABI正常组,两组比较差异有统计学意义。Logistic回归分析,年龄、高血压、糖尿病、吸烟同ABI升高（ABI〉1．4）相关。年龄、糖尿病和ABI升高与冠脉钙化、病变长度相关。结论ABI升高同UA冠状动脉斑块钙化、病变长度增加相关。     

CTA评价冠状动脉粥样硬化管腔狭窄程度及其高危因素的相关性

 目的 应用冠状动脉CT血管成像(computed tomography angiography,CTA)确定有高危因素且非糖尿病无冠心病症状者冠状动脉粥样硬化(coronary atherosclerotic, CA)管腔狭窄程度,评价其与高危因素的相关性。方法 在非糖尿病无冠心病症状健康查体的人群中,收集有高危因素(性别、年龄、高血压、高脂血症)者,并将其分为单项高危因素组、多项高危因素(2项及以上高危因素)组。统计有高危因素者冠状动脉粥样硬化管腔狭窄程度。结果 单项及多项高危因素各组,管腔狭窄程度为Ⅰ级的发病率最高,随年龄的增长,管腔狭窄程度为Ⅱ级、Ⅲ级的发病率也增长。有高危因素且冠状动脉粥样硬化管腔狭窄＞50%者与对照组对比,单项高危因素且＞40岁组及多项高危因素各组,冠状动脉粥样硬化管腔狭窄＞50%的发生率与对照组有显著差异(P=0.0011,P=0.048,P=0.020);单项高危因素且＜40岁组,管腔狭窄＞50%的发生率与对照组无显著差异(P=0.6013)。结论 在非糖尿病无症状人群中,冠状动脉CTA在预测冠状动脉病粥样硬化严重程度方面提供重要的信息。     

应用CTA对无症状非糖尿病高危人群冠状动脉粥样硬化的研究

 目的 应用冠状动脉CT血管成像技术(computed tomography angiography,CTA)确定有高危因素,且非糖尿病无冠心病症状者冠状动脉粥样硬化(coronary atherosclerotic, CA)发生率,评价其与高危因素的相关性。方法 在非糖尿病无冠心病症状健康查体的人群中,收集有高危因素(性别、年龄、高血压、高脂血症)者并将其分为单项高危因素组、2项及以上高危因素组。统计有高危因素者冠状动脉粥样硬化发生率。结果 单因素分析发现,年龄和性别对CA的发生率有统计学差异(χ² ＝4.6,P＝0.0032,χ²＝6.5,P＝0.0108)。高危因素logistic回归分析得出,年龄与CA的发生率有相关性(OR＝1.77,CI＝1.19～2.66)。高危因素组间比较,多项高危因素CA的发生率有统计学差异(χ²＝4.44,P=0.035)。结论 在非糖尿病无症状人群中,CTA能够在一次扫描提供冠状动脉斑块的重要信息,性别、年龄可能对发生CA病变带来更大的风险,作为一项无创性的检查,CTA在CA的诊断中发挥重要作用。
     

亚高原地区高血压与外周动脉硬化相关性探讨

目的探讨亚高原城镇人群高血压与外周动脉硬化的相关性。方法随机从2009年10月～2010年4月昆明城镇企事业单位到我院体检的18岁以上人群中,抽取检出血压异常且符合高血压诊断标准的受检者1000名作为高血压组,同时随机抽取673名体检提示血压正常者作为对照组,采用日本科林公司生产的VP-1000全自动测量仪对两组患者作肱踝脉搏波传导速度（baPWV）及踝臂指数（ABI）测量。结果高血压组baPWV值明显高于对照组（P〈0.01）,ABI≤0.9检出率明显高于对照组（P〈0.01）。结论亚高原地区城镇人群高血压与动脉硬化密切相关,选择对动脉僵硬度有影响的降压药物,有效控制血压,同时指导患者进行间断性适量的有氧运动,对预防及延缓高血压靶器官损害及心血管事件的发生,延长患者寿命具有重要意义。     

某部飞行员踝臂指数的测定及临床意义

 目的 测定飞行员踝臂指数(ankle brachial pressure index,ABI)并探讨其临床意义.方法 选择某部125名飞行员,按年龄分为≤30岁、30～39岁及≥40岁3组,每一年龄段再按是否吸烟分为两组,分别测定ABI、收缩压、舒张压、体重指数.对比各年龄段吸烟组与非吸烟组飞行员ABI,分别计算ABI与年龄、飞行时间的直线相关系数.结果 (1)≤30岁和30～39岁飞行员吸烟组臂踝脉搏波传导速度与非吸烟组比较差异无统计学意义(P＞0.01);(2)≥40岁组飞行员吸烟组ABI较非吸烟组显著降低(P＜0.01);(3)pearson相关分析表明,ABI与年龄、飞行时间呈正相关(P＜0.01).结论 ≥40岁飞行员吸烟组与非吸烟组ABI差异具有统计学意义,年龄、飞行时间与ABI显著相关.     

Wall shear rates differ between the normal carotid, femoral, and brachial arteries: an in vivo MRI study

PURPOSE: To investigate wall shear rates in vivo in the common carotid, brachial, and superficial femoral arteries using very high resolution magnetic resonance imaging (MRI) phase contrast measurements. MATERIALS AND METHODS: Mean, maximum, and minimum wall shear rate and an oscillatory shear index were measured for 20 volunteers, aged 23.3 +/- 1.9 years, in the three arteries, using phase contrast imaging with 0.0625 mm2 resolution and three-dimensional paraboloid fitting. RESULTS: The superficial femoral artery had the lowest mean (130.3 +/- 13.1 second(-1)), maximum (735.8 +/- 32.4 second(-1)), and minimum (-224.5 +/- 17.0 second(-1)) wall shear rate, as well as the highest oscillatory shear index (0.21 +/- 0.02). All values were significantly different (P < 0.05) from both the brachial artery and the common carotid artery values. The highest mean (333.3 +/- 13.6 second(-1)) and minimum (117.9 +/- 24.5 second(-1)) wall shear rates and the lowest oscillatory shear index (0 +/- 0) were found in the common carotid artery. CONCLUSION: It is possible to measure wall shear rate in vivo in different arteries using MRI with very high resolution. The findings exhibit the in vivo environment of wall shear rates and suggest a nonuniform distribution of wall shear rates throughout the arterial system.     

The prevalence and correlation of carotid artery calcification on panoramic radiographs and peripheral arterial disease in a population from the Republic of Korea: the Dong-gu study

Objectives:

The aim of this study was to determine the prevalence of carotid artery calcification (CAC) detected on panoramic radiographs and peripheral arterial disease (PAD), and to evaluate the difference in the prevalence of PAD between patients with CAC and patients without CAC detectable by panoramic radiograph.

Methods:

The surveyed population consisted of 4078 subjects aged 50 years and older (1410 males and 2668 females) who underwent medical and dental examination in Gwangju city, South Korea. Two oral and maxillofacial radiologists interpreted the panoramic radiographs for the presence of carotid artery calcification. A trained research technician measured the ankle–brachial index (ABI). An ABI <0.9 in either leg was considered evidence of PAD.

Results:

The prevalence of CAC on panoramic radiographs was 6.2% and that of PAD was 2.6%. Subjects with CAC had a significantly higher prevalence of PAD than those without CAC (5.5% vs 2.4%, respectively). The presence of CAC on panoramic radiographs was associated with PAD (odds ratio 1.84; 95% confidence interval 1.01–3.36) after adjusting for potential confounders.

Conclusion:

CACs detected on panoramic radiographs were positively associated with PAD in middle-aged and older Korean adults.     

Association between ankle angle at initial contact and biomechanical ACL injury risk factors in male during self-selected single-leg landing

BackgroundIncreasing the ankle plantar-flexion angle at initial contact (IC) during landing reduces the impact features associated with landing, such as the vertical ground reaction force and loading rate, potentially affecting the risk of anterior cruciate ligament (ACL) injury. However, the relationships between the ankle plantar-flexion angle at IC and the previously identified biomechanical factors related to noncontact ACL injury have not been studied.Research questionThus, the purpose of this study was to determine whether significant relationships exist between the ankle plantar-flexion angle at IC and the biomechanical factors related to noncontact ACL injury.MethodsThe peak anterior tibial shear force, peak external knee valgus moment, peak knee valgus angle, and combined peak external knee valgus plus tibial internal rotation moments were measured in 26 individuals while performing self-selected, single-leg landing. Pearson correlation analyses were performed to assess the relationships between the ankle plantar-flexion angle at IC and the biomechanical factors mentioned above.ResultsThe greater ankle plantar-flexion angle at IC was related to smaller the peak knee valgus moment (r = −0.5, p = 0.009) and the combined peak knee valgus plus internal rotation moments (r = −0.58, p = 0.001).SignificanceThese results suggest that large ankle plantar-flexion angle at IC might be associated with lesser loading of the knee frontal plane and altering the self-selective ankle angle may result in biomechanical changes associated with ACL injury risk.     

放置胆管支架与儿童ERCP术后胰腺炎的关系

 目的 探讨放置胆管支架与儿童内镜逆行胰胆管造影(ERCP)术后胰腺炎(PEP)的关系。方法 基于美国国家住院患者样本(NIS)数据库中的儿童患者,使用复杂抽样资料的Logistic回归和多重填补方法进行评价,并根据性别进行亚组分析。结果 放置胆管支架的儿童患者,患PEP的风险较未放置胆管支架的高(OR: 1.44,95% CI: 1.05~1.99,P=0.0246)。亚组分析结果显示,男性儿童放置胆管支架者患PEP风险约为未放置者的1.9倍(OR: 1.89,95% CI: 1.08~3.31,P=0.0262);女性儿童患者未发现放置胆管支架与PEP患病相关联。结论 放置胆管支架与儿童ERCP术后发生PEP风险增加相关,因此对儿童放置胆管支架时,应采取预防措施、停止或更改手术方式等,以降低发生PEP的危险。     

Association between medical resources and the proportion of oldest-old in the Chinese population

The potential association between medical resources and the proportion of oldest-old (90 years of age and above) in the Chinese population was examined,and we found that the higher proportion of oldest-old was associated with the higher number of beds in hospitals and health centers.