踝臂指数对急性缺血性脑卒中患者的预测价值。
Predictive value of the ankle brachial index in patients with acute ischemic stroke.
作者信息
Tziomalos Konstantinos, Giampatzis Vasilios, Bouziana Stella, Pavlidis Athinodoros, Spanou Marianna, Papadopoulou Maria, Kagelidis Giannis, Boutari Chrysoula, Savopoulos Christos, Hatzitolios Apostolos
机构信息
First Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, AHEPA Hospital, Thessaloniki, Greece.
出版信息
Vasa. 2014 Jan;43(1):55-61. doi: 10.1024/0301-1526/a000328.
BACKGROUND
Peripheral arterial disease (PAD) is frequently present in patients with acute ischemic stroke. However, there are limited data regarding the association between ankle brachial index (ABI) ≤ 0.90 (which is diagnostic of PAD) or > 1.40 (suggesting calcified arteries) and the severity of stroke and in-hospital outcome in this population. We aimed to evaluate these associations in patients with acute ischemic stroke.
PATIENTS AND METHODS
We prospectively studied 342 consecutive patients admitted for acute ischemic stroke (37.4 % males, mean age 78.8 ± 6.4 years). The severity of stroke was assessed with the National Institutes of Health Stroke Scale (NIHSS)and the modified Rankin scale (mRS) at admission. The outcome was assessed with the mRS and dependency (mRS 2 - 5) at discharge and in-hospital mortality.
RESULTS
An ABI ≤ 0.90 was present in 24.6 % of the patients whereas 68.1 % had ABI 0.91 - 1.40 and 7.3 % had ABI > 1.40. At admission, the NIHSS score did not differ between the 3 groups (10.4 ± 10.6, 8.3 ± 9.3 and 9.3 ± 9.4, respectively). The mRS score was also comparable in the 3 groups (3.6 ± 1.7, 3.1 ± 1.8 and 3.5 ± 2.3, respectively). At discharge, the mRS score did not differ between the 3 groups (2.9 ± 2.2, 2.3 ± 2.1 and 2.7 ± 2.5, respectively) and dependency rates were also comparable (59.5, 47.6 and 53.3 %, respectively). In-hospital mortality was almost two-times higher in patients with ABI ≤ 0.90 than in patients with ABI 0.91 - 1.40 or > 1.40 but this difference was not significant (10.9, 6.6 and 6.3 %, respectively).
CONCLUSIONS
An ABI ≤ 0.90 or > 1.40 does not appear to be associated with more severe stroke or worse in-hospital outcome in patients with acute ischemic stroke.
背景
外周动脉疾病（PAD）在急性缺血性脑卒中患者中很常见。然而，关于踝臂指数（ABI）≤0.90（诊断为PAD）或>1.40（提示动脉钙化）与该人群脑卒中严重程度及住院结局之间的关联，相关数据有限。我们旨在评估急性缺血性脑卒中患者中的这些关联。
患者与方法
我们前瞻性地研究了342例因急性缺血性脑卒中入院的连续患者（男性占37.4%，平均年龄78.8±6.4岁）。入院时采用美国国立卫生研究院卒中量表（NIHSS）和改良Rankin量表（mRS）评估脑卒中严重程度。出院时采用mRS和依赖程度（mRS 2 - 5）评估结局，并评估住院死亡率。
结果
24.6%的患者ABI≤0.90，68.1%的患者ABI为0.91 - 1.40，7.3%的患者ABI>1.40。入院时，三组患者的NIHSS评分无差异（分别为10.4±10.6、8.3±9.3和9.3±9.4）。三组患者的mRS评分也相当（分别为3.6±1.7、3.1±1.8和3.5±2.3）。出院时，三组患者的mRS评分无差异（分别为2.9±2.2、2.3±2.1和2.7±2.5），依赖率也相当（分别为59.5%、47.6%和53.3%）。ABI≤0.90的患者住院死亡率几乎是ABI为0.91 - 1.40或>1.40患者的两倍，但差异无统计学意义（分别为10.9%、6.6%和6.3%）。
结论
在急性缺血性脑卒中患者中，ABI≤0.90或>1.40似乎与更严重的脑卒中或更差的住院结局无关。
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