Ishizuka Kentaro, Hoshino Takao, Uchiyama Shinichiro
Department of Neurology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
Department of Neurology, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan.
J Stroke Cerebrovasc Dis. 2014 Nov-Dec;23(10):2506-2510. doi: 10.1016/j.jstrokecerebrovasdis.2013.12.026. Epub 2014 Oct 3.
Few studies have examined the relationship between abnormal ankle-brachial index (ABI) and short-term outcome in patients with acute ischemic stroke (AIS).
We included 209 consecutive patients with AIS admitted to our hospital and divided them into abnormal ABI (≤.9) and normal ABI (>.9) groups. We defined neurologic deterioration (ND) as an increase of 1 or more points in the National Institutes of Health Stroke Scale score within 7 days of stroke onset. Clinical characteristics were compared between the 2 groups. Then, we performed a multiple logistic regression analysis to identify independent predictors of ND. In the multivariate analysis, the ABI values were used separately as binary variables in different cutoff thresholds (.9, 1.0, and 1.1).
Of the 209 patients, 24 (11.5%) had an abnormal ABI. The patients in abnormal and normal ABI groups showed significant differences in carotid arterial stenosis (37.5% versus 18.9%; P = .040), intracranial artery stenosis (54.2% versus 18.9%; P < .001), and previous use of antiplatelet drugs (58.3% versus 29.2%; P = .004). According to the multivariate analysis, ABIs of .9 or less and 1.0 or less were positively associated with ND (odds ratio [OR], 1.74; 95% confidence interval [CI], 1.03-2.89; P = .034 and OR, 1.63; 95% CI, 1.05-2.54; P = .027, respectively), whereas an ABI value of 1.1 or less was not an independent predictor of ND (OR, 1.17; 95% CI, 0.79-1.74; P = .43).
Not only an ABI of .9 or less but also an ABI of 1.0 or less can be a predictor of ND in patients with AIS.
很少有研究探讨急性缺血性卒中（AIS）患者踝臂指数（ABI）异常与短期预后之间的关系。
我们纳入了连续209例入住我院的AIS患者，并将他们分为ABI异常（≤0.9）组和ABI正常（>0.9）组。我们将神经功能恶化（ND）定义为卒中发作后7天内美国国立卫生研究院卒中量表评分增加1分或更多。比较两组的临床特征。然后，我们进行多因素逻辑回归分析以确定ND的独立预测因素。在多变量分析中，ABI值在不同的临界阈值（0.9、1.0和1.1）下分别用作二元变量。
在209例患者中，24例（11.5%）ABI异常。ABI异常组和正常组患者在颈动脉狭窄（37.5%对18.9%；P = 0.040）、颅内动脉狭窄（54.2%对18.9%；P < 0.001）以及既往使用抗血小板药物（58.3%对29.2%；P = 0.004）方面存在显著差异。根据多变量分析，ABI≤0.9和≤1.0与ND呈正相关（优势比[OR]分别为1.74；95%置信区间[CI]为1.03 - 2.89；P = 0.034和OR为1.63；95%CI为1.05 - 2.54；P = 0.027），而ABI≤1.1不是ND的独立预测因素（OR为1.17；95%CI为0.79 - 1.74；P = 0.43）。
不仅ABI≤0.9，而且ABI≤1.0都可能是AIS患者发生ND的预测因素。
