Department of Cardiovascular Medicine, the Second Affiliated Hospital of Nanchang University, 330006, NO 1 Mingde Road, Nanchang, Jiangxi, China.
Curr Hypertens Rep. 2019 Feb 12;21(2):15. doi: 10.1007/s11906-019-0917-z.
Traditionally, the term peripheral vascular disease (PAD) is restricted to the occlusive arterial disease in the leg, but now, the connotation of PAD is more widespread as it encompasses all extracoronary and extracerebral vascular disease. The incidence of PAD is increasing worldwide; therefore, it is necessary to diagnose PAD at an early stage.
Oscillometric BP device is widely used for four-limb measurement in clinical practice and provides several parameters for evaluating inter-limb BP difference, such as ankle-brachial index (OS-ABI), inter-arm BP differences (IAD), and inter-ankle BP difference (IAND). Using angiographic results as reference, the ABI, IAD, and IAND from an oscillometric BP device have been demonstrated having high accuracy for diagnosis of PAD. Meanwhile, combination of these parameters could further improve the accuracy of PAD, including the occlusive artery disease in the arm, leg, and aorta. For example, some patients with severe PAD in the leg have normal ABI; in this situation, an increased sIAND could confirm the diagnosis of PAD in the leg. Because ABI, IAD, and IAND from inter-limb oscillometric BP measurement can also predict adverse prognosis, we encourage the use of an oscillometric device to measure four-limb BP and to evaluate the inter-limb BP difference.
传统上，外周血管疾病（PAD）一词仅限于腿部的闭塞性动脉疾病，但现在，PAD 的内涵更为广泛，因为它包括所有颅外和颅外血管疾病。PAD 的发病率在全球范围内正在增加；因此，有必要早期诊断 PAD。
血压振荡测量设备在临床实践中广泛用于四肢测量，并提供了几个参数来评估四肢血压差异，例如踝臂指数（ABI）、臂间血压差异（IAD）和踝间血压差异（IAND）。使用血管造影结果作为参考，已经证明血压振荡测量设备的 ABI、IAD 和 IAND 对于诊断 PAD 具有很高的准确性。同时，这些参数的组合可以进一步提高 PAD 的准确性，包括手臂、腿部和主动脉的闭塞性动脉疾病。例如，一些腿部严重 PAD 的患者 ABI 正常；在这种情况下，增加的 sIAND 可以确认腿部 PAD 的诊断。因为四肢血压振荡测量的 ABI、IAD 和 IAND 也可以预测不良预后，因此我们鼓励使用血压振荡设备测量四肢血压并评估四肢血压差异。
