Ting A C, Cheng S W, Wu L L, Cheung G C
Department of Surgery, University of Hong Kong Medical Centre, Queen Mary Hospital, Pokfulam, China.
Angiology. 1999 Oct;50(10):831-6. doi: 10.1177/000331979905001007.
To define the role of air plethysmography (APG) in the clinical diagnosis and quantitative assessment of chronic venous insufficiency (CVI), APG studies were performed on 582 limbs in 291 patients with signs and symptoms of CVI. One hundred and thirty-one limbs were classified into group I (no evidence of CVI), 291 into group II (mild CVI), and 160 into group III (advanced CVI). On APG, the mean venous filling index (VFI) was 1.45 mL/s, 3.90 mL/s, and 5.25 mL/s in groups I, II, and III respectively (p<0.05). The mean ejection fraction (EF) and mean residual volume fraction (RVF) also showed significant differences between the limbs with CVI and the contralateral normal limbs, but the values were similar for the different severities of CVI limbs. The amount of overlap in VFI, EF, and RVF values among the clinical groups was considerable. Discrimination analysis derived a VFI value of 2.67 mL/s as a cutoff point between normal limbs and limbs with CVI, with a positive predictive value of 96%. In conclusion, APG is a simple and noninvasive test for quantitative assessment of the different components of CVI, valvular reflux, and calf muscle pump function. However, only VFI correlated significantly with the severity of CVI. VFI, with its high positive predictive value, may be useful in diagnosis of CVI, and it may serve as an objective quantitative measurement for monitoring the effect of treatment.
为明确空气体积描记法（APG）在慢性静脉功能不全（CVI）临床诊断及定量评估中的作用，对291例有CVI体征和症状患者的582条肢体进行了APG研究。131条肢体被归入I组（无CVI证据），291条归入II组（轻度CVI），160条归入III组（重度CVI）。在APG检查中，I组、II组和III组的平均静脉充盈指数（VFI）分别为1.45 mL/s、3.90 mL/s和5.25 mL/s（p<0.05）。平均射血分数（EF）和平均残余容积分数（RVF）在有CVI的肢体与对侧正常肢体之间也显示出显著差异，但不同严重程度CVI肢体的值相似。临床组间VFI、EF和RVF值的重叠量相当大。判别分析得出VFI值2.67 mL/s作为正常肢体与有CVI肢体的分界点，阳性预测值为96%。总之，APG是一种用于定量评估CVI不同组成部分、瓣膜反流和小腿肌肉泵功能的简单无创检查。然而，只有VFI与CVI的严重程度显著相关。VFI具有较高的阳性预测值，可能有助于CVI的诊断，并且可作为监测治疗效果的客观定量指标。
