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糖尿病足患者下肢数字减影血管造影(DSA)特征及踝肱指数

[Digital subtract arteriographic (DSA) characteristics of lower extremities and ankle-brachial index in patients with diabetic feet].

作者信息

Chen Da-Wei, Lu Wu-Sheng, Wang Chun, Jiao He, Song Yuan-Xia, Chen Li-Hong, Ou Qing, Ran Xing-Wu

机构信息

Diabetic Foot Care Center, West China Hospital, Sichuan University, Chengdu 610041, China.

出版信息

Sichuan Da Xue Xue Bao Yi Xue Ban. 2010 Jul;41(4):731-3, 750.

Abstract

OBJECTIVE

To evaluate the Digital Subtract Arteriography (DSA) characteristics of lower limb arterial diseases in patients with diabetic feet and to explore the correlation between DSA and Ankle-brachial index (ABI).

METHODS

Fifty-two patients with diabetic feet were recruited in this study. ABI and DSA of bilateral lower extremities were examined to assess the severity of vasculopathy. The relationship between ABI and DSA was analyzed.

RESULTS

ABI values for 91 lower extremities were obtained, with a mean of 0.73 +/- 10.43 (0.15-1.97), among which 19.8% ranged from 0.9 to 1.3, 69.2% were less than 0.9, and 11% were more than 1.3. Based on the integrated angiographic images, the arteries with < or = 50% degree of stenosis, 50%-99% degree of stenosis and occlusion comprised 49.5%, 22%, and 28.5% for femoral artery; 79.1%, 14.3%, and 6.6% for popliteal artery; 25.3%, 8.8%, and 65.9% for anterior tibial artery; 29.7%, 14.3%, and 56% for posterior tibial artery; 25.3%, 20.9%, and 53.8% for peroneal artery; and 54.9%, 14.3%, and 30.8% for dorsal pedis artery. Forty (50.5%) limbs had three or more above-mentioned arteries occluded simultaneously. The average vascular score was 8.5 +/- 4.3 with a range between 0 and 18. The spearman correlation analysis showed that ABI inversely correlated with artery stenosis score (r = -0. 588, P < 0.05).

CONCLUSION

Arterial diseases of lower extremities in patients with diabetic feet are wide-spread, ranging from femoral artery to the dorsal pedis artery. Multiple segments of arteries are involved. Severe stenosis and occlusion are more common in anterior and posterial tibial arteries, and peroneal artery.

摘要

目的

评估糖尿病足患者下肢动脉疾病的数字减影血管造影(DSA)特征,并探讨DSA与踝肱指数(ABI)之间的相关性。

方法

本研究纳入52例糖尿病足患者。检测双侧下肢的ABI和DSA,以评估血管病变的严重程度。分析ABI与DSA之间的关系。

结果

共获得91条下肢的ABI值,平均值为0.73±10.43(0.15 - 1.97),其中19.8%在0.9至1.3之间,69.2%小于0.9,11%大于1.3。根据综合血管造影图像,股动脉狭窄程度≤50%、50% - 99%和闭塞的动脉分别占49.5%、22%和28.5%;腘动脉分别占79.1%、14.3%和6.6%;胫前动脉分别占25.3%、8.8%和65.9%;胫后动脉分别占29.7%、14.3%和56%;腓动脉分别占25.3%、20.9%和53.8%;足背动脉分别占54.9%、14.3%和30.8%。40条(50.5%)肢体同时有三条或更多上述动脉闭塞。平均血管评分为8.5±4.3,范围在0至18之间。Spearman相关性分析显示ABI与动脉狭窄评分呈负相关(r = -0.588,P < 0.05)。

结论

糖尿病足患者下肢动脉疾病广泛存在,从股动脉到足背动脉均有累及。多节段动脉受累。胫前动脉、胫后动脉和腓动脉中严重狭窄和闭塞更为常见。

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