Alnaeb Mohamad E, Crabtree Vincent P, Boutin Adrien, Mikhailidis Dimitri P, Seifalian Alexander M, Hamilton George
Vascular Unit, Royal Free Hampstead NHS Trust Hospital, London, United Kingdom.
Angiology. 2007 Oct-Nov;58(5):579-85. doi: 10.1177/0003319707305685.
A new optical device based on the photoplethysmograph (PPG) method and an innovative algorithm for the assessment of lower-extremity peripheral arterial disease was investigated prospectively in patients with type II diabetes. This new functional PPG (fPPG) technique uses a cuffless functional test to assess diabetic peripheral arterial disease without operator dependency and the incompressible arteries, issues associated with ankle brachial pressure index (ABPI) measurement. Diabetic patients (n = 24; 47 legs; age, 70 +/- 3 years) were recruited from the vascular clinic, and controls (n = 15; 30 legs; age, 66 +/- 5 years) were recruited from the orthopedic outpatient clinic. All underwent resting ABPI, fPPG, and duplex angiography (DA) as "gold standard." fPPG requires the placement of an optical probe on the toe for acquisition of pulsatile arterial perfusion for a period of 30 seconds with the leg in supine and raised at 45 degrees positions. The data were analyzed, and indices were generated by an automated computer system. In those with diabetes, fPPG correlated significantly with DA (r = -.68, P < .01) and ABPI (r = -.65, P < .01). We also found a significant correlation between ABPI and DA (r = .81, P < .01). The analysis of the receiver operator curve showed that optimum sensitivity and specificity for ABPI and fPPG were 80% and 93% and 83% and 71%, respectively, against DA. This method uses changes in pulsatile arterial blood volume using a simple cuffless functional test. The fPPG investigation period was much shorter (5 minutes) with independence of operator skills, whereas ABPI took longer (10-15 minutes) and required operator experience. Although the fPPG results are promising, further improvement (eg, by incorporation of functional skin color and temperature changes) is required to improve the sensitivity and specificity of the system.
一种基于光电容积脉搏波描记法（PPG）的新型光学装置以及一种用于评估下肢外周动脉疾病的创新算法，在II型糖尿病患者中进行了前瞻性研究。这种新型功能性PPG（fPPG）技术采用无袖带功能测试来评估糖尿病外周动脉疾病，无需操作人员依赖，也不存在与踝臂压力指数（ABPI）测量相关的不可压缩动脉问题。从血管诊所招募了糖尿病患者（n = 24；47条腿；年龄，70±3岁），从骨科门诊招募了对照组（n = 15；30条腿；年龄，66±5岁）。所有人都接受了静息ABPI、fPPG和作为“金标准”的双功血管造影（DA）检查。fPPG需要将一个光学探头放置在脚趾上，在腿部仰卧并抬高45度的位置采集30秒的搏动性动脉灌注数据。对数据进行了分析，并由一个自动计算机系统生成指标。在糖尿病患者中，fPPG与DA（r = -.68，P <.01）和ABPI（r = -.65，P <.01）显著相关。我们还发现ABPI与DA之间存在显著相关性（r =.81，P <.01）。对受试者工作特征曲线的分析表明，ABPI和fPPG相对于DA的最佳敏感性和特异性分别为80%和93%以及83%和71%。该方法通过一个简单的无袖带功能测试利用搏动性动脉血容量的变化。fPPG的检查时间要短得多（5分钟），且不依赖操作人员的技能，而ABPI则需要更长时间（10 - 15分钟）且需要操作人员的经验。尽管fPPG的结果很有前景，但仍需要进一步改进（例如，通过纳入功能性皮肤颜色和温度变化）以提高该系统的敏感性和特异性。
