Hôpital Bichat, AP-HP, Paris, France.
Eur J Vasc Endovasc Surg. 2011 Jan;41(1):110-6. doi: 10.1016/j.ejvs.2010.09.020. Epub 2010 Nov 20.
Ankle brachial index (ABI) is a simple method to screen peripheral arterial disease (PAD) and to evaluate cardiovascular (CV) prognosis in the general population. Measuring it requires a hand-held Doppler probe but it can be done also with an automatic device. ABI is an effective tool for clinical practice or clinical studies. However, in diabetic patients, it has some specific caveats. Sensitivity of the standard threshold of 0.9 appears to be lower in diabetic patients with complications. Moreover, highly frequent arterial medial calcifications in diabetes increase ABI. It has been demonstrated that measurements >1.3 are well correlated with both an increased prevalence of PAD and CV risk. Therefore, ABI thresholds of less than 0.9 and more than 1.3 are highly suspicious for PAD and high CV risk in diabetic patients. However, when there is concomitant clinical peripheral neuropathy or high risk of arterial calcification, the efficiency of ABI seems to be limited. In this case, other methods should be applied, toe pressure, in particular. Thus, the ABI could be used in patients with diabetes, but values should be interpreted with precision, according to the clinical situation.
踝肱指数（ABI）是一种用于筛查外周动脉疾病（PAD）和评估普通人群心血管（CV）预后的简单方法。测量 ABI 需要使用手持式多普勒探头，但也可以使用自动设备进行测量。ABI 是临床实践或临床研究的有效工具。然而，在糖尿病患者中，它有一些特定的注意事项。在有并发症的糖尿病患者中，标准阈值为 0.9 的敏感度似乎较低。此外，糖尿病患者中高频的动脉中层钙化会增加 ABI。研究表明，测量值>1.3 与 PAD 和 CV 风险的增加密切相关。因此，在糖尿病患者中，ABI 阈值小于 0.9 和大于 1.3 高度提示 PAD 和高 CV 风险。然而，当存在同时存在的临床周围神经病变或动脉钙化的高风险时，ABI 的效率似乎受到限制。在这种情况下，应该应用其他方法，特别是趾压。因此，ABI 可以用于糖尿病患者，但应根据临床情况精确解读数值。
