比较严重主动脉瓣狭窄患者压力（踝臂血压指数）和流量（应变计容积描记法和反应性充血）测量在诊断外周动脉疾病中的应用。
Comparative study of pressure (ankle-brachial pressure index) and flow (strain gauge plethysmography and reactive hyperaemia) measurements in diagnosis of peripheral arterial disease in patients with severe aortic stenosis.
机构信息
Department of Internal Medicine II-Cardiology, Pulmonology and Angiology, University Hospital Bonn, Bonn, Germany.
Institute of Medical Biometry, Informatics and Epidemiology, University Hospital Bonn, Bonn, Germany.
出版信息
PLoS One. 2019 Jul 30;14(7):e0220510. doi: 10.1371/journal.pone.0220510. eCollection 2019.
BACKGROUND
The measurement of the ankle-brachial pressure index is a straightforward method for the detection of peripheral disease in the lower limbs. Only a few old studies with small numbers of patients have been conducted comparing the gold standard, ankle-brachial pressure index measurement, with strain gauge plethysmography and reactive hyperaemia for detecting peripheral arterial disease. The purpose of this study was to evaluate the feasibility and accuracy of strain gauge plethysmography values compared with the Doppler ultrasound method, ankle-brachial pressure index, in the assessment of peripheral arterial disease, especially in patients with severe aortic stenosis.
METHODS
221 ankle-brachial pressure index measurements and strain gauge plethysmography measurements of patients with suspected peripheral arterial disease, diagnosed peripheral arterial disease with or without aortic stenosis were compared.
RESULTS
Irrespective of aortic stenosis in patients with and without peripheral arterial disease, the resting arterial blood flow was within the normal range. In patients with aortic stenosis, the time-to-peak flow couldn't detect peripheral arterial disease and was found to be a false negative. In patients without aortic stenosis, time-to-peak flow correlated well with the ankle-brachial pressure index for detecting peripheral arterial disease. Peak flow at 5 seconds was the one of the flow values that correlated with ankle-brachial pressure index and detected peripheral arterial disease in patients with and without aortic stenosis.
CONCLUSION
Peak flow at 5 seconds is one of flow value that correlated well with ankle-brachial pressure index in detecting peripheral arterial disease in patients with and without aortic stenosis. Detection of peripheral arterial disease in patients with severe aortic stenosis seems to be less sensitive with flow measurements than with ankle-brachial pressure index.
背景
踝臂血压指数的测量是一种用于检测下肢周围疾病的简单方法。只有少数几项针对少量患者的旧研究将金标准——踝臂血压指数测量与应变计体积描记法和反应性充血进行了比较，以检测外周动脉疾病。本研究旨在评估应变计体积描记法值与多普勒超声方法、踝臂血压指数在评估外周动脉疾病方面的可行性和准确性，特别是在严重主动脉瓣狭窄患者中。
方法
比较了 221 例疑似外周动脉疾病、诊断为有或无主动脉瓣狭窄的外周动脉疾病患者的踝臂血压指数测量值和应变计体积描记法测量值。
结果
无论患者是否有主动脉瓣狭窄，静息动脉血流均在正常范围内。在主动脉瓣狭窄患者中，峰值血流时间无法检测外周动脉疾病，结果为假阴性。在无主动脉瓣狭窄的患者中，峰值血流时间与踝臂血压指数检测外周动脉疾病相关性良好。5 秒时的峰值流量是与踝臂血压指数相关且可检测出有或无主动脉瓣狭窄患者外周动脉疾病的流量值之一。
结论
在有或无主动脉瓣狭窄的患者中，5 秒时的峰值流量是与踝臂血压指数相关性良好的流量值之一，可用于检测外周动脉疾病。在严重主动脉瓣狭窄患者中，使用流量测量法检测外周动脉疾病的敏感性似乎不如踝臂血压指数。
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