[动脉闭塞性疾病（AOD）患者严重肢体缺血的总体结局]

[General outcome in critical limb ischemia in patients with arterial occlusive disease (AOD)].

作者信息

Dilić M, Kurtalić E, Gavrankapetanović F, Gavrankapetanović I, Pehar S, Terzić O, Koco D

机构信息

Institut za vaskularne bolesti, Klinicki centar Univerziteta u Sarajevu.

出版信息

Med Arh. 2001;55(2):77-80.

PMID:11769045

Abstract

BACKGROUND

Recent vascular studies suggests that patients with arterial occlusive disease (AOD) and with elevated score of multiple risk factors (MRF), especially diabetes mellitus, have an increased prevalence of critical limb ischaemia, increased incidence of lower limb amputations, and an overall poor outcome of their AOD. The aim of this study is to evaluate an overall outcome of AOD, Fontaine stage III and IV, and to correlate their outcome with score of MRF.

METHODS

We enrolled a group of 136 patients (99 males and 37 females), with an average of 63.7 yrs and SD 12.2 all with AOD, Fontaine stage III and IV. We divided pts in three groups--pts on medicament treatment--MT group, pts for lower limb amputation--AMP group, and pts for vascular surgery. According to their clinical stage we had group in Fontaine stage III (n-48), and Fontaine IV (n-88). We followed 9 clinical variables: age, gender, tobacco, arterial hypertension, diabetes mellitus, hyperlipidaemia, level of fibrinogen, coronary ischaemic disease and cerebrovascular disease.

RESULTS

In MT group we had n-91 (66.9%) with MRF score of 3.42. In Fontaine stage III we had 37 pts with MRF score of 3.89, and in Fontaine stage IV we had 54 pts with MRF score of 3.37. In AMP group we had n-23 pts (16.9%) with MRF score of 3.39, and all pts were in F IV stage. In VH group we had n-22 pts (16.1%) with MRF score of 3.1. In VH group 50% of pts were in F IV stage. In overall group (n-136) we had a significant number of Fontaine IV stage pts, p < 0.01.

CONCLUSIONS

We had a high risk group of patients, with mean MRF score of 3.42, 23 pts (16.9%) were referred for lower limb amputation, and 23 pts (16.9%) for vascular surgery. MRF score correlate with overall outcome of AOD, r = 0.72, p < 0.001.

摘要

背景

近期的血管研究表明，患有动脉闭塞性疾病（AOD）且多项危险因素（MRF）评分升高，尤其是患有糖尿病的患者，严重肢体缺血的患病率增加，下肢截肢的发生率增加，其AOD的总体预后较差。本研究的目的是评估AOD（Fontaine III期和IV期）的总体预后，并将其预后与MRF评分相关联。

方法

我们纳入了一组136例患者（99例男性和37例女性），平均年龄63.7岁，标准差12.2，均患有AOD（Fontaine III期和IV期）。我们将患者分为三组——药物治疗组（MT组）、下肢截肢组（AMP组）和血管手术组。根据临床分期，我们有Fontaine III期患者（n = 48）和Fontaine IV期患者（n = 88）。我们跟踪了9个临床变量：年龄、性别、吸烟、动脉高血压、糖尿病、高脂血症、纤维蛋白原水平、冠状动脉缺血性疾病和脑血管疾病。

结果

在MT组中，有91例患者（66.9%），MRF评分为3.42。在Fontaine III期，有37例患者，MRF评分为3.89；在Fontaine IV期，有54例患者，MRF评分为3.37。在AMP组中，有23例患者（16.9%），MRF评分为3.39，所有患者均处于F IV期。在VH组中，有22例患者（16.1%），MRF评分为3.1。在VH组中，50%的患者处于F IV期。在总体组（n = 136）中，Fontaine IV期患者数量显著，p < 0.01。