Chiesa Roberto, Marone Enrico Maria, Limoni Costanzo, Volonté Marina, Schaefer Eckhard, Petrini Orlando
Scientific Institute Hospital San Raffaele, "Vita-Salute" University, Milan, Italy.
Angiology. 2007 Aug-Sep;58(4):440-9. doi: 10.1177/0003319706292012.
The study evaluates to what extent symptoms of chronic venous insufficiency (CVI) and functional venous incompetence as investigated using color-coded duplex ultrasonography may interfere with activities of daily living (ADLs). This study comprises a cross-sectional survey conducted in urban areas surrounding 24 Italian cities. A spontaneous sample of 5,187 subjects (4,457 women [mean age, 54 years] and 730 men [mean age, 61 years]), selected by advertising on television and in newspapers, underwent a clinical examination that included duplex ultrasonography in 3 vein segments in both legs to determine the presence and severity of venous reflux. Subjective perception of lower limb symptoms of CVI and the effect of leg problems on the ability to perform normal ADLs are assessed by means of a self-administered questionnaire. Most of the respondents have some CVI symptoms, with women being 1.5 to 3 times as likely as men to report leg symptoms. The risk of developing the most frequent subjective symptoms such as heaviness and tiredness in the legs is not statistically significantly different for younger subjects compared with older subjects. Advanced age is considered to be a relevant risk factor only for heat sensation and swollen legs. Persons living in southern Italy are at higher risk of almost all lower limb symptoms. Results of duplex ultrasonography performed on 3875 subjects show that fewer than 1 in 5 young persons, regardless of sex, manifest some degree of venous reflux (primarily mild symptoms). The risk of developing venous incompetence increases rapidly with age until it triples among subjects 50 years and older. Adjusting for all other factors, men are on average 1.5 times as likely as childless women to have venous reflux, and the risk increases in the case of family history of CVI or (among women) in the case of past pregnancies. More women than men report that their leg problems affect their ADLs. Pregnancy and living in the south contribute to a reduction in the ability to perform most heavy housework. Although milder lower limb symptoms such as evening heaviness and tiredness in the legs may begin early in life, venous reflux and related symptoms of heat sensation and swollen legs become more pronounced with age, and their severity can be disabling for those afflicted.
本研究评估了使用彩色编码双功超声检查所调查的慢性静脉功能不全（CVI）症状和功能性静脉反流在多大程度上可能干扰日常生活活动（ADL）。本研究包括在意大利24个城市周边城区进行的一项横断面调查。通过电视和报纸广告选取了5187名受试者（4457名女性[平均年龄54岁]和730名男性[平均年龄61岁]）的自发样本，他们接受了临床检查，包括对双腿3个静脉节段进行双功超声检查，以确定静脉反流的存在和严重程度。通过一份自我管理问卷评估CVI下肢症状的主观感受以及腿部问题对进行正常ADL能力的影响。大多数受访者有一些CVI症状，女性报告腿部症状的可能性是男性的1.5至3倍。与老年受试者相比，年轻受试者出现腿部最常见主观症状（如沉重感和疲劳感）的风险在统计学上无显著差异。高龄仅被认为是热感和腿部肿胀的一个相关风险因素。生活在意大利南部的人几乎所有下肢症状的风险都更高。对3875名受试者进行的双功超声检查结果显示，无论性别，每5名年轻人中表现出某种程度静脉反流（主要是轻度症状）的不到1人。静脉功能不全的风险随着年龄迅速增加，直到50岁及以上受试者中风险增加两倍。在调整所有其他因素后，男性出现静脉反流的平均可能性是无子女女性的1.5倍，并且在有CVI家族史的情况下（女性中）或过去有过怀孕史的情况下风险会增加。报告腿部问题影响其ADL的女性比男性更多。怀孕和生活在南部会导致进行大多数繁重家务的能力下降。虽然较轻的下肢症状（如傍晚腿部沉重感和疲劳感）可能在生命早期就开始出现，但静脉反流以及相关症状（如热感和腿部肿胀）会随着年龄增长而更加明显，其严重程度可能使患者致残。
