踝臂指数评价冠心病患者下肢外周动脉病临床研究

目的通过测量踝臂指数(ankle-brachial index, ABI)评价我国住院冠心病(coronary arterial disease, CAD)患者下肢外周动脉病(Peripheral arterial disease, PAD)的发病情况.方法对入院的163例CAD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 163例CAD患者中发现70例合并外周动脉病(平均ABI 0.63).与非PAD组相比,PAD组患者与年龄 (P=0.000),糖尿病史(P=0.000) 有统计学意义,而与吸烟史(P=0.731), 高血压病史(P=0.187)和血脂异常(P=0.614)无统计学意义.结论通过测量ABI确诊PAD简便易行;CAD患者易合并PAD,冠状动脉旁路移植术(Coronary artery bypass grafting, CABG)患者合并PAD尤为常见;CAD合并PAD多见于高龄和糖尿病.

Lower extremity peripheral arterial disease in hospitalized patients with coronary arterial disease

Objective To access the prevalence of peripheral arterial disease (PAD) in hospitalized patients with coronary arterial disease (CAD) by measuring the ankle-brachial index (ABI). Methods Chinese patients of Coronary artery bypass grafting, Percutaenous transluminal coronary angioplasty and implanted stent, as well as myocardial infarction were invited to participate prior to hospital discharge. Data regarding cardiovascular risk factors, history of previous PAD, physical examination, and ABI were collected. An ABI less than or equal to 0.9 or a history of previous lower extremity vascular intervention was considered to be indicative of significant PAD. A total of 163 patients (111 men and 52 women) were recruited. Results By measuring the ABI, 70 patients (40 men) were positive for PAD. Of the patients, only 5 (7.1%) had previous documented PAD. Physicians are unaware of the presence of PAD in 92.9% of their patients with the condition. Increasing age and diabetes mellitus were at high risk for PAD. Diabetes mellitus is present in about 55.7% patients with PAD. Patients with PAD were older (P=0.000), were more likely to have hypertension (P=0.187), a smoking history (P=0.731) and dyslipoproteinemia (P=0.614). Conclusion Identification of patients with PAD by measuring the ankle-brachial index is easily done. Hospitalized patients with CAD are likely to have concomitant PAD. PAD in patients with CAD is more popular in CABG or advanced age or diabetes.