Nag Falguni, De Abhishek, Hazra Avijit, Chatterjee Gobinda, Ghosh Arghyaprasun, Surana Trupti V
Department of Dermatology, IPGMER & SSKM Hospital, Kolkatta, West Bengal, India.
Int Wound J. 2014 Oct;11(5):546-9. doi: 10.1111/iwj.12003. Epub 2012 Nov 22.
Chronic venous ulcer can often be associated with asymptomatic peripheral arterial disease (PAD), which usually remains undiagnosed adding significantly to the morbidity of these patients. The Ankle-Brachial Pressure Index (ABPI) is suggested for PAD evaluation. Many PAD studies were conducted in western countries, but there is a scarcity of data on the prevalence of PAD in clinical venous ulcer patient in developing countries. We conducted a study in a tertiary care hospital of eastern part of India to find out the prevalence of PAD in venous ulcer patients, and also to find the sensitivity of ABPI as a diagnostic tool in these patients. We evaluated clinically diagnosed patients with venous ulcer using ABPI and Colour Doppler study for the presence of PAD. Possible associations such as age, sex, body mass index (BMI), smoking, hypertension and atherosclerosis were studied. All results were analysed using the software Statistica version 6. PAD was present in 23 (27·71%) patients. Older age, longer duration, smoking, high BMI and hypertension were found to be significantly associated with PAD. A very strong level of agreement was found between venous Doppler and ABPI. Assessment for the presence of PAD is important in all clinically diagnosed venous ulcer patients. ABPI being a simple, non-invasive outpatient department (OPD)-based procedure, can be routinely used in cases of venous ulcer to find out the hidden cases of PAD even in developing countries.
慢性静脉溃疡常与无症状外周动脉疾病（PAD）相关，而后者通常未被诊断出来，这显著增加了这些患者的发病率。建议采用踝臂压力指数（ABPI）评估PAD。许多关于PAD的研究是在西方国家进行的，但发展中国家临床静脉溃疡患者中PAD患病率的数据却很匮乏。我们在印度东部一家三级护理医院开展了一项研究，以查明静脉溃疡患者中PAD的患病率，并确定ABPI作为这些患者诊断工具的敏感性。我们使用ABPI和彩色多普勒检查对临床诊断为静脉溃疡的患者进行评估，以确定是否存在PAD。研究了年龄、性别、体重指数（BMI）、吸烟、高血压和动脉粥样硬化等可能的关联因素。所有结果均使用Statistica 6版软件进行分析。23例（27.71%）患者存在PAD。发现年龄较大、病程较长、吸烟、高BMI和高血压与PAD显著相关。静脉多普勒检查和ABPI之间存在非常高度的一致性。对所有临床诊断为静脉溃疡的患者进行PAD评估很重要。ABPI作为一种基于门诊（OPD）的简单、非侵入性检查方法，即使在发展中国家，也可常规用于静脉溃疡病例，以发现隐匿的PAD病例。
