van Langen Herman, van Gurp Johan, Rubbens Leonie
Vascular laboratory, VieCuri Medical Centre, Venlo, The Netherlands.
Vasc Med. 2009 Aug;14(3):221-6. doi: 10.1177/1358863X08101017.
The ankle-brachial index (ABI) post exercise is claimed to play a complementary role in the diagnosis or exclusion of intermittent claudication (IC). The interobserver variability of ABI measurements at rest and post exercise in patients with typical symptoms of IC is the subject of this study with emphasis on ABI post exercise. ABI at rest and post exercise were measured in both legs of 20 patients with typical symptoms of IC. After 15 minutes of rest these measurements were repeated by another observer. Analysis according to Bland-Altman was performed on 40 paired leg measurements at rest and 40 paired leg measurements post exercise. The average ABI at rest for the first observer was 0.84 (standard deviation +/-0.18) and for the second was 0.84 (+/-0.17). Post-exercise averages were 0.73 (+/-0.25) and 0.74 (+/-0.27), respectively. The standard deviation of the ABI difference between observers was 0.08 at rest and 0.15 post exercise. The interobserver variability of the ABI was 10% at rest and 21% post exercise. The interobserver variability post exercise is an important given when rules are defined about how the ABI post exercise translates into a more reliable and objective diagnosis of IC.
运动后踝臂指数（ABI）据称在间歇性跛行（IC）的诊断或排除中起辅助作用。本研究以运动后ABI为重点，探讨了有典型IC症状患者静息及运动后ABI测量的观察者间变异性。对20例有典型IC症状患者的双腿进行了静息及运动后ABI测量。休息15分钟后，由另一名观察者重复这些测量。对40对静息腿部测量值和40对运动后腿部测量值进行了Bland-Altman分析。第一位观察者静息时的平均ABI为0.84（标准差±0.18），第二位观察者为0.84（±0.17）。运动后的平均值分别为0.73（±0.25）和0.74（±0.27）。观察者间ABI差值的标准差静息时为0.08，运动后为0.15。观察者间ABI的变异性静息时为10%，运动后为21%。在定义运动后ABI如何转化为更可靠、客观的IC诊断规则时，运动后观察者间变异性是一个重要考量因素。
