Kiuchi Shunsuke, Hisatake Shinji, Watanabe Ippei, Toda Mikihito, Kabuki Takayuki, Oka Takashi, Dobashi Shintaro, Ikeda Takanori
Department of Cardiovascular Medicine, Toho University Faculty of Medicine, Tokyo, Japan.
Cardiol Res. 2016 Oct;7(5):161-166. doi: 10.14740/cr508e. Epub 2016 Nov 3.
Some peripheral artery disease (PAD) patients have normal ankle brachial index (ABI) (0.9 - 1.4), although ABI is a useful parameter for the diagnosis of PAD. We investigated whether other parameters of ABI report sheet are useful to detect these patients.
We initially enrolled 3,912 patients (7,824 limbs) who underwent ABI for the first time. Subjects who have normal ABI were divided into the PAD group (n = 136) and the non-PAD group (n = 240) by lower extremity ultrasonography. We investigated blood pressures (BP) (systolic (SBP), diastolic (DBP), mean (mBP) and pulse pressure (PP)), heart rate, upstroke time (UT), and %mean arterial pressure (%MAP).
SBP, mBP, PP, UT, and %MAP in the PAD group were significantly higher. A multivariate analysis showed that mBP, DBP, PP, UT and %MAP were independently associated with the presence of PAD (mBP: odds ratio (OR) 2.30, 95% confidence interval (CI) 1.22 - 4.37, P = 0.010; DBP: OR 0.52, 95% CI 0.28 - 0.97, P = 0.039; PP: OR 1.30, 95% CI 0.69 - 2.46, P = 0.041; UT: OR 3.40, 95% CI 2.03 - 5.83, P < 0.001; %MAP: OR 1.77, 95% CI 1.05 - 2.98, P = 0.031). Maximal area under the curve (AUC) of BPs for associating PAD was PP. The cut-off value of PP was 53.0 mm Hg (sensitivity 0.500, specificity 0.721, AUC 0.628, 95% CI 0.569 - 0.687).
The present study demonstrated that BPs are associated with PAD in patients with normal ABI. The measurement of BPs could provide additional information for the diagnosis of PAD.
尽管踝臂指数（ABI）是诊断外周动脉疾病（PAD）的一个有用参数，但一些PAD患者的ABI值正常（0.9 - 1.4）。我们研究了ABI报告单上的其他参数是否有助于检测这些患者。
我们最初纳入了3912例首次接受ABI检测的患者（7824条肢体）。通过下肢超声检查，将ABI正常的受试者分为PAD组（n = 136）和非PAD组（n = 240）。我们研究了血压（BP）（收缩压（SBP）、舒张压（DBP）、平均压（mBP）和脉压（PP））、心率、上升时间（UT）和平均动脉压百分比（%MAP）。
PAD组的SBP、mBP、PP、UT和%MAP显著更高。多因素分析显示，mBP、DBP、PP、UT和%MAP与PAD的存在独立相关（mBP：比值比（OR）2.30，95%置信区间（CI）1.22 - 4.37，P = 0.010；DBP：OR 0.52，95% CI 0.28 - 0.97，P = 0.039；PP：OR 1.30，95% CI 0.69 - 2.46，P = 0.041；UT：OR 3.40，95% CI 2.03 - 5.83，P < 0.001；%MAP：OR 1.77，95% CI 1.05 - 2.98，P = 0.031）。与PAD相关的血压的最大曲线下面积（AUC）是PP。PP的截断值为53.0 mmHg（敏感性0.500，特异性0.721，AUC 0.628，95% CI 0.569 - 0.687）。
本研究表明，血压与ABI正常的患者的PAD相关。血压测量可为PAD的诊断提供额外信息。
