在患有钙化和非钙化下肢动脉的糖尿病患者中，使用超声成像和自动示波测量法比较舒张期与收缩期踝肱压力指数
Diastolic versus systolic ankle-brachial pressure index using ultrasound imaging & automated oscillometric measurement in diabetic patients with calcified and non-calcified lower limb arteries.
作者信息
Asbeutah Akram M, AlMajran Abdullah A, Asfar Sami K
机构信息
Department of Radiologic Sciences, Faculty of Allied Health Sciences, Kuwait University, P.O.Box 31470, Kuwait, 90805, Kuwait.
Department of Community Medicine & Behavioural Sciences, Health Sciences Centre, Faculty of Medicine, Kuwait University, Kuwait, Kuwait.
出版信息
BMC Cardiovasc Disord. 2016 Oct 26;16(1):202. doi: 10.1186/s12872-016-0377-1.
BACKGROUND
Ankle-brachial pressure index-systolic (ABI-s) can be falsely elevated in the presence of calcified lower limb arteries in some diabetic patients and therefore loses its value in this cohort of patients. We aim at investigating the feasibility of using the diastolic (ABI-d) instead of ABI-s to calculate the ABI in diabetic patients with calcified limb arteries.
METHODS
A total of 51 patients were chosen from the diabetic foot clinic. Twenty six of these patients had calcified leg arteries by Duplex scan (Group A) and 25 patients did not have calcifications in their leg arteries (Group B). Twenty five healthy volunteers were enrolled in the study for group C and they were matched with other participants from group B and A in age and sex. ABI measurement was performed using "boso ABI-system 100 machine". Systolic ABI (ABI-s) and diastolic ABI (ABI-d) were calculated based on bilateral brachial and ankle oscillometric pressures. ABI is considered normal when it is ≥0.9. Repeated measures ANOVA test was used to test for comparing mean scores for ABI-s and ABI-d across the three groups. Statistical significance is considered when P < .05.
RESULTS
The mean age of all participants (±SD) was 64.30 ± 7.1 years (range, 50-82 years). ABI-s mean ± SD was 1.3 ± 0.10 (range, 1.18-1.58) in group A patients, 1.07 ± 0.05 (range, 1-1.16) in group B patients, and 1.06 ± 0.05 (range, 1-1.16) in group C volunteers. While ABI-d mean ± SD was 1.07 ± 0.05 (range, 1.1-1.17) in group A patients, 1.06 ± 0.05 (1-1.14) in group B patients, and 1.05 ± 0.04 (range, 1.01-1.14) in group C volunteers. In group A, repeated measures ANOVA test showed statistical significant difference between ABI-s and ABI-d (P < 0.001) whereas in group B & C was not (P > 0.05).
CONCLUSIONS
ABI-d may be helpful and can be used as a complementary measure instead of ABI-s in falsely elevated ABI caused by partial incompressible vessel.
背景
在一些糖尿病患者中，当存在下肢动脉钙化时，踝肱压力指数收缩压（ABI-s）可能会被错误地升高，因此在这类患者群体中失去了其价值。我们旨在研究在患有下肢动脉钙化的糖尿病患者中，使用舒张压踝肱压力指数（ABI-d）而非ABI-s来计算踝肱压力指数的可行性。
方法
从糖尿病足诊所选取了51例患者。其中26例患者经双功超声扫描显示下肢动脉钙化（A组），25例患者下肢动脉无钙化（B组）。25名健康志愿者纳入研究作为C组，他们在年龄和性别上与B组和A组的其他参与者相匹配。使用“博索ABI系统100机器”进行ABI测量。根据双侧肱动脉和踝部示波压力计算收缩压ABI（ABI-s）和舒张压ABI（ABI-d）。当ABI≥0.9时被认为正常。采用重复测量方差分析来比较三组中ABI-s和ABI-d的平均得分。当P <.05时认为具有统计学意义。
结果
所有参与者的平均年龄（±标准差）为64.30±7.1岁（范围为50 - 82岁）。A组患者的ABI-s平均值±标准差为1.3±0.10（范围为1.18 - 1.58），B组患者为1.07±0.05（范围为1 - 1.16），C组志愿者为1.06±0.05（范围为1 - 1.16）。而A组患者的ABI-d平均值±标准差为1.07±0.05（范围为1.1 - 1.17），B组患者为1.06±0.05（1 - 1.14），C组志愿者为1.05±0.04（范围为1.01 - 1.14）。在A组中，重复测量方差分析显示ABI-s和ABI-d之间存在统计学显著差异（P < 0.001），而在B组和C组中则无差异（P > 0.05）。
结论
在由部分不可压缩血管导致的ABI错误升高情况下，ABI-d可能有用，可作为ABI-s的补充测量方法。
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