Hasimu Buaijiaer, Li Jue, Nakayama Tomohiro, Yu Jinming, Yang Jingang, Li Xiankai, Hu Dayi
Heart, Lung and Blood Vessel Center, Tongji University, Shanghai, P.R. China.
Hypertens Res. 2006 Jan;29(1):23-8. doi: 10.1291/hypres.29.23.
To obtain reliable data on the epidemiology, co-morbidities and risk factor profile of peripheral arterial disease (PAD), we evaluated the clinical significance of the ankle brachial index (ABI) as an indicator of PAD in Chinese patients at high cardiovascular (CV) risk. ABI was measured in 5,646 Chinese patients at high CV risk, and PAD was defined as an ABI<0.9 in either leg. Multivariable logistic regression analyses were performed to identify factors associated with PAD. A total of 5,263 patients were analyzed, 52.9% male, mean age 67.3 years, mean body mass index (BMI) 24.2 kg/m2, mean systolic/diastolic blood pressure (SBP/DBP) 139/80.7 mmHg. The prevalence of PAD in the total group of patients was 25.4%, and the prevalence was higher in females than in males (27.1% vs. 23.9%; odds ratio [OR]: 1.64). Patients with PAD were older than those without PAD (72.3+/-9.9 years vs. 65.6+/-11.7 years; OR: 1.06), and more frequently had diabetes (43.3% vs. 31.3%; OR: 2.02), coronary heart disease (CHD) (27.0% vs. 18.8%; OR: 1.67), stroke (44.4% vs. 28.3%; OR: 1.78), lipid disorders (57.2% vs. 50.7%; OR: 1.3) and a smoking habit (42.7% vs. 38.6%; OR: 1.52). The ORs for the PAD group compared with the non-PAD group demonstrated that these conditions were inversely related to ABI. Statin, angiotensin-converting enzyme-inhibitors and antiplatelet agents were only used in 40.5%, 53.6% and 69.1% of PAD patients, respectively. The data demonstrated the high prevalence and low treatment of PAD in Chinese patients at high CV risk. A lower ABI was associated with generalized atherosclerosis. Based on these findings, ABI should be a routine measurement in high risk patients. Aggressive medication was required in these patients.
为获取有关外周动脉疾病（PAD）的流行病学、合并症及危险因素概况的可靠数据，我们评估了踝臂指数（ABI）作为中国心血管（CV）高危患者PAD指标的临床意义。对5646例中国CV高危患者测量了ABI，将任一腿部ABI<0.9定义为PAD。进行多变量逻辑回归分析以确定与PAD相关的因素。共分析了5263例患者，男性占52.9%，平均年龄67.3岁，平均体重指数（BMI）24.2kg/m²，平均收缩压/舒张压（SBP/DBP）139/80.7mmHg。患者总体中PAD患病率为25.4%，女性患病率高于男性（27.1%对23.9%；优势比[OR]：1.64）。PAD患者比无PAD患者年龄更大（72.3±9.9岁对65.6±11.7岁；OR：1.06），且更常患有糖尿病（43.3%对31.3%；OR：2.02）、冠心病（CHD）（27.0%对18.8%；OR：1.67）、中风（44.4%对28.3%；OR：1.78）、血脂异常（57.2%对50.7%；OR：1.3）及有吸烟习惯（42.7%对38.6%；OR：1.52）。与非PAD组相比，PAD组的OR表明这些情况与ABI呈负相关。他汀类药物、血管紧张素转换酶抑制剂和抗血小板药物在PAD患者中的使用比例分别仅为40.5%、53.6%和69.1%。数据表明中国CV高危患者中PAD患病率高且治疗率低。较低的ABI与全身性动脉粥样硬化相关。基于这些发现，ABI应作为高危患者的常规测量项目。这些患者需要积极用药。
