Division of Endocrinology, Diabetes, and Metabolism, SUNY Upstate Medical University, Syracuse, New York, USA.
Endocr Pract. 2013 May-Jun;19(3):439-43. doi: 10.4158/EP12172.OR.
To compare the use of photoplethysmography (PPG) and Doppler techniques to measure the ankle brachial index (ABI) for the evaluation of peripheral arterial disease (PAD) in individuals with diabetes.
Consecutive patients with diabetes (n = 103) referred for PAD evaluation had ABI measured by PPG and Doppler techniques in our diabetes center. Medical records were reviewed, and the results of the Doppler and PPG testing were compared.
Mean age was 60 years, 57% were female, and 79% had type 2 diabetes with an average duration of 17 years. PPG readings could not be obtained in 3 individuals. Of 200 limbs evaluated, 17 (8.5%) had noncompressible (NC) vessels by both techniques. In the remaining 183 limbs, the correlation coefficient comparing the two methods was 0.864. Mean ABI values were 1.11 ± 0.14 for Doppler and 1.12 ± 0.14 for PPG. The sensitivity of PPG compared to the Doppler technique for detection of an abnormal result was 88.2%, and the specificity was 99.4%. ABI results were classified as discordant if Doppler and PPG varied by more than 0.15, placing them in different diagnostic categories (abnormal low [≤0.9], borderline [0.91-0.99], normal [1.0-1.4], or abnormal high [>1.4 or NC vessels]). There were only 4 (2%) discordant results.
We found excellent concordance between PPG and the gold standard Doppler technique for ABI measurement in individuals with diabetes. PPG requires less training and takes less time to perform, making it highly suitable for use in an office setting.
比较光体积描记法（PPG）和多普勒技术测量踝臂指数（ABI）在评估糖尿病患者外周动脉疾病（PAD）中的应用。
在我们的糖尿病中心，连续有 PAD 评估指征的糖尿病患者（n=103）接受了 PPG 和多普勒技术的 ABI 测量。回顾病历记录，并比较了多普勒和 PPG 检测的结果。
平均年龄为 60 岁，57%为女性，79%为 2 型糖尿病，平均病程为 17 年。有 3 个人的 PPG 读数无法获得。在 200 条肢体中，有 17 条（8.5%）用两种技术均显示为不可压缩（NC）血管。在其余 183 条肢体中，两种方法的相关系数为 0.864。多普勒法的平均 ABI 值为 1.11±0.14，PPG 法为 1.12±0.14。PPG 法检测异常结果的敏感性为 88.2%，特异性为 99.4%。如果多普勒和 PPG 的结果相差超过 0.15，即被归类为不一致结果，则将其分为不同的诊断类别（异常低值[≤0.9]、临界值[0.91-0.99]、正常[1.0-1.4]或异常高值[>1.4 或 NC 血管]）。仅有 4 个（2%）不一致的结果。
我们发现 PPG 与多普勒技术在糖尿病患者的 ABI 测量中具有极好的一致性。PPG 所需的培训较少，操作时间也较短，非常适合在办公室环境中使用。
