Wikström Johan, Hansen Tomas, Johansson Lars, Ahlström Håkan, Lind Lars
Department of Radiology, Uppsala University Hospital, Uppsala, Sweden.
J Vasc Surg. 2009 Aug;50(2):330-4. doi: 10.1016/j.jvs.2009.03.008. Epub 2009 May 15.
This study evaluated the distribution and degree of symmetry of lower extremity artery stenoses in an unselected elderly population and its relation to a reduced ankle-brachial index (ABI) measurement.
This was a population-based study set in a university hospital comprising 306 randomly selected 70-year-old individuals participating in the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study. Whole-body magnetic resonance angiography (MRA) and bilateral ABI measurements were performed in each participant. The prevalence of stenosis >or=50% was evaluated in nine different arterial segments in both legs: common iliac artery (CIA), external iliac artery (EIA), common femoral artery (CFA), superficial femoral artery (SFA), popliteal artery (PA), tibioperoneal trunk (TPTr), anterior tibial artery (ATA), posterior tibial artery (PTA), and peroneal artery. The relations between the prevalences of stenosis in different arterial segments in the right and left leg were assessed. An evaluation was made of the relation between a >or=50% stenosis and an ABI <0.9 in the different segments.
The prevalence of stenosis was 0% to 21%. In all segments, a stenosis was more commonly found in one of the legs only than in both legs. The prevalence of >or=50% stenosis in the right leg only, left leg only, and both legs was 0.3%, 0.7%, and 0% in the CIA; 0.3%, 1.0%, and 0.7% in the EIA; 0%, 0%, and 0% in the CFA; 2.0%, 1.3%, and 0.7% in the SFA; 0.7%, 0.7%, and 0.3% in the PA; 1.0%, 0.7%, and 0% in the TPTr; 5.6%, 6.3%, and 8.6% in the ATA; 0.7%, 1.7%, and 0% in the peroneal artery; and in 2.0%, 2.7%, and 3.4% in the PTA. When the legs were compared, a significant correlation was found for the presence of a >or=50% stenosis in the EIA, SFA, PA, ATA, and PTA. Seventeen participants showed ABI <0.9. In logistic regression analysis with ABI <0.9 as dependent variable, stenosis in SFA, ATA, and PTA were the major independent variables to explain a low ABI in both of the legs.
The distribution of stenosis differs substantially when legs are compared. Despite this difference, stenosis in SFA, ATA, and PTA was the major determinant of a low ABI in both of the legs.
本研究评估了未经过挑选的老年人群中下肢动脉狭窄的分布及对称程度，及其与踝肱指数（ABI）测量值降低之间的关系。
这是一项在大学医院开展的基于人群的研究，纳入了306名随机选取的70岁个体，他们参与了乌普萨拉老年人血管前瞻性研究（PIVUS）。对每位参与者进行全身磁共振血管造影（MRA）及双侧ABI测量。评估双腿九个不同动脉节段中狭窄≥50%的患病率，这些节段包括：髂总动脉（CIA）、髂外动脉（EIA）、股总动脉（CFA）、股浅动脉（SFA）、腘动脉（PA）、胫腓干（TPTr）、胫前动脉（ATA）、胫后动脉（PTA）和腓动脉。评估左右腿不同动脉节段狭窄患病率之间的关系。评估不同节段中狭窄≥50%与ABI<0.9之间的关系。
狭窄患病率为0%至21%。在所有节段中，狭窄更常见于单腿而非双腿。仅右下肢、仅左下肢和双下肢狭窄≥50%的患病率在CIA中分别为0.3%、0.7%和0%；在EIA中分别为0.3%、1.0%和0.7%；在CFA中分别为0%、0%和0%；在SFA中分别为2.0%、1.3%和0.7%；在PA中分别为0.7%、0.7%和0.3%；在TPTr中分别为1.0%、0.7%和0%；在ATA中分别为5.6%、6.3%和8.6%；在腓动脉中分别为0.7%、1.7%和0%；在PTA中分别为2.0%、2.7%和3.4%。比较双腿时，发现EIA、SFA、PA、ATA和PTA中存在狭窄≥50%有显著相关性。17名参与者的ABI<0.9。在以ABI<0.9作为因变量的逻辑回归分析中，SFA、ATA和PTA中的狭窄是解释双腿ABI降低的主要独立变量。
比较双腿时，狭窄分布存在显著差异。尽管存在这种差异，但SFA、ATA和PTA中的狭窄是双腿ABI降低的主要决定因素。
