冠心病及等危症患者中踝臂指数异常的临床研究

目的 观察冠心病及等危症患者合并外周动脉疾病(PAD)的发病情况,探讨踝臂指数(ABI)在临床上的应用价值.方法 选取621例冠心病及等危症患者,收集相关临床资料并检测相关生化指标,采用科林动脉硬化检测仪测量受试者的ABI值,应用SPSS 13.0统计软件进行数据分析和处理.结果 冠心病及等危症患者中合并PAD者为169例,总的患病率为27.2%,女性PAD的患病率34.6%(129/373)]明显高于男性16.1%(40/248),P＜0.01].PAD组年龄、总胆固醇显著高于非PAD组年龄分别为(65±10)、(60±10)岁,t值为5.847;总胆固醇分别为(5.4±1.1)、(5.1±1.1)mmol/L,t值为2.626;P均＜0.01],多因素Logistic回归分析显示,性别(OR 0.35,95% CI 0.214～0.572)、年龄(OR 1.05,95% CI 1.024～1.072)、总胆固醇(OR 1.52,95% CI 1.089～2.129)是高危患者伴PAD的危险因素(P均＜0.05);同时患有冠心病、糖尿病和缺血性脑卒中三种疾病的患者PAD患病率达50.0%.结论 ABI是筛查冠心病及等危症患者伴PAD的简单易行又可靠的指标,性别、年龄、总胆固醇是冠心病及等危症患者ABI降低的危险因素.

Abnormal ankle brachial index in patients with equal-risk to coronary heart disease

Objective To observe the proportion of the peripheral artery disease (PAD) in patients with equal-risk to coronary heart disease and to explore the clinical value of ankle brachial index(ABI). Methods Six hundred and twenty-one cases with equal-risk to coronary heart disease were recruited to the study. Their clinical data and biochemical indicators were collected for further analysis. The value of ABI, which was popularly used in screening PAD, was measured by Oscillometric measurement. All data were statistically analyzed by SPSS 13.0 software. Results There were 169 cases had PAD,the proportion of it was 27.2%. The proportion of PAD in male and female were 34.6% and 16.1% respectively,which had significant difference(P ＜0.01). Compared with NonPAD group,the average age (65 ± 10 years vs. 60 ± 10 years,P ＜0.01) and total cholesterol level (5.4 ± 1.1 mmol/L vs. (5.1 ± 1.1) mtool/L, P ＜ 0.01) were significantly higher in PAD group. Logistic regression analysis showed that gender,age and total cholesterol were major risk factors of PAD in patients with equal-risk to coronary heart disease. Proportion of PAD was up to 50.0% in patients with combined coronary heart disease,ischemic stroke and diabetes. Conclusions ABI is a feasible and reliable index for screening PAD in patients with equal-risk to coronary heart disease. Gender,age and total cholesterol are major risk factors of low ABI in patients with equal-risk to coronary heart disease.