踝肱指数评价高血压患者下肢动脉病变的临床意义

目的用踝肱指数（ABI）评价高血压患者下肢外周动脉疾病（PAD）发病情况及相关危险因素。方法采用日本欧姆龙全自动动脉硬化检测仪VP-1000对80例高血压患者进行ABI测定,以ABI≤0.9为异常,分成PAD组和非PAD组,比较两组病人的年龄、病程、体重指数（BMI）及空腹血脂、血糖、肾功能和高敏C-反应蛋白（hs-CRP）等生化指标,并比较两组共患病情况及吸烟率等指标。结果检出高血压患者下肢血管病变28例（35.0%）,其中无症状者12例。PAD组患者年龄大、病程长,hs-CRP明显升高,且PAD组合并糖尿病（DM）比例升高,和非PAD组比较,有显著性统计学差异（P〈0.01）;PAD组患者甘油三酯（TG）、低密度脂蛋白胆固醇（LDL-C）、空腹血糖（FBG）升高,且合并冠心病（CHD）、吸烟者比例升高,和非PAD组比较差异有统计学意义（P〈0.05）。结论ABI可用于早期诊断高血压患者下肢血管病变,炎症可能参与了下肢动脉病变的发生、发展。ABI降低是心血管疾病的独立预测因子。

The clinical value of ankle brachial index in the evaluation of peripheral artery disease in patients with hypertension

Objective To investigate the ankle brachial index （ABI） in the diagnosis of perpheral artery disease （PAD） and its＇ cardiovascular risk factors in patients with hypertension. Methods Eighty patients with hypertension were detected ABI, with （Japan, OUMULONG VP- 1000） automatically atherosclerosis Doppler diagnostic instrument of blood vessel. ABI≤0. 9 was used as the diagnostic criteria for PAD identification, and the patients were divided into group PAD （ABI ≤0.9 ） and group non PAD （ABI 〉 0.9 ）. Age, hypertension duration, body mass index （BM1） were recorded, at the same time, their fasting blood glucose （FBG）, total cholesterol （TC）, triglyceride （TG）, low density lipoprotein cholesterol（ LDL- C ）, creatinine（ Cr）, uric acid （UA）, high sensitive C -reactive protein （hs - CRP） were also measured. Blood samples were taken in the morning without breakfast. Results 28 patients （35.0%） with abnormal ABI （ ABI ≤0.9） were detected, 12 of them had not been found any symptoms. Group PAD showed significantly older age, longer hypertension duration, much higher serum hs - CRP levels and combined with diabetes increased than group non PAD （P 〈 0. 01 ） ; Group PAD also showed higher serum TG, LDL -C, FBG levels, and combined with coronary heart disease （CHD）, smoking patients increased than those in group non PAD （P 〈0. 05 ）. Conclusion Detection of ABI could early make the diagnosis of PAD in patients with hypertension, and inflammation reaction exists in PAD patients. Low ABI is independent risk factors of cardiovascular disease.