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外周动脉疾病中的性别差异与截肢风险——单中心经验

Gender Differences and Amputation Risk in Peripheral Artery Disease-A Single-Center Experience.

作者信息

Onofrei Viviana, Adam Cristina Andreea, Marcu Dragos Traian Marius, Leon Maria-Magdalena, Cumpăt Carmen, Mitu Florin, Cojocaru Doina-Clementina

机构信息

Department of Medical Specialties I, "Grigore T. Popa" University of Medicine and Pharmacy, University Street No. 16, 700115 Iasi, Romania.

"St. Spiridon" Clinical Emergency Hospital, Cardiology Department Independence Boulevard No. 1, 700111 Iasi, Romania.

出版信息

Diagnostics (Basel). 2023 Oct 7;13(19):3145. doi: 10.3390/diagnostics13193145.

DOI:10.3390/diagnostics13193145
PMID:37835888
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10572938/
Abstract

: Peripheral artery disease (PAD) affects both genders, but the knowledge of clinical and therapeutic aspects particular to each gender has a prognostic value, modulating the risk of amputation and helping to reduce the risk of death or the occurrence of an acute vascular event secondary to optimal management. : We conducted a retrospective, descriptive study that included 652 patients with PAD who were evaluated at "St. Spiridon" Hospital's Cardiology Department and divided into two groups according to gender: women (100 cases) and men (552 cases). We evaluated demographics, anthropometric data, as well as clinical and paraclinical parameters in the two groups. : Men had a lower mean age ( < 0.001), higher mean BMI ( = 0.049) and were more frequent smokers. ( = 0.008). Hypercholesterolemia ( = 0.026), obesity ( = 0.009), concomitant cerebrovascular ( = 0.005) and chronic kidney disease ( = 0.046) were more common in women, while coronary artery disease ( = 0.033) was more common in men. The number of angiographic stenotic lesions ( = 0.037) is a statistically significant parameter in our study, with both genders predominantly associated with stenotic lesions. In addition, directly proportional relationships were found between smoking, uric acid, inflammatory markers, and the number of stenotic lesions and thromboses or the ankle-brachial index (ABI). In the subgroup of men, the number of stenotic and thrombosed lesions positively correlated with the ABI value ( < 0.001). The presence of more than three cardiovascular risk factors ( = 0.001) and serum triglyceride levels ( = 0.019) significantly correlated with the number of angiographically detected lesions. We applied several risk scores (PREVENT III, Finnvasc Score, or GermanVasc risk score) in our study group for prognostic purposes, without showing statistically significant differences between genders. Men, rest pain, gangrene, smoking status, the presence of more than three cardiovascular risk factors, or a serum HDL-cholesterol level below 40 mg/dL ( < 0.001 for all parameters) are independent predictors associated with amputation in our study group. : In our study, we demonstrated that several clinical-paraclinical particularities guide the diagnosis, providing the clinician with prognostic and therapeutic tools to choose the optimal management with maximum benefits.

摘要

外周动脉疾病(PAD)在两性中均有发生,但了解每种性别的临床和治疗方面的特点具有预后价值,可调节截肢风险,并有助于降低死亡风险或因优化管理而继发急性血管事件的发生率。

我们进行了一项回顾性描述性研究,纳入了652例在“圣斯皮里东”医院心内科接受评估的PAD患者,并根据性别分为两组:女性(100例)和男性(552例)。我们评估了两组患者的人口统计学、人体测量数据以及临床和辅助检查参数。

男性的平均年龄较低(<0.001),平均体重指数较高(=0.049),吸烟更为频繁(=0.008)。高胆固醇血症(=0.026)、肥胖(=0.009)、合并脑血管疾病(=0.005)和慢性肾病(=0.046)在女性中更为常见,而冠状动脉疾病(=0.033)在男性中更为常见。血管造影狭窄病变的数量(=0.037)是我们研究中的一个统计学显著参数,两性主要都与狭窄病变相关。此外,发现吸烟、尿酸、炎症标志物与狭窄病变及血栓形成的数量或踝臂指数(ABI)之间存在正比关系。在男性亚组中,狭窄和血栓形成病变的数量与ABI值呈正相关(<0.001)。存在超过三个心血管危险因素(=0.001)和血清甘油三酯水平(=0.019)与血管造影检测到的病变数量显著相关。我们在研究组中应用了几种风险评分(PREVENT III、芬兰血管评分或德国血管风险评分)用于预后评估,未显示出性别之间的统计学显著差异。在我们的研究组中,男性、静息痛、坏疽、吸烟状况、存在超过三个心血管危险因素或血清高密度脂蛋白胆固醇水平低于40mg/dL(所有参数均<0.001)是与截肢相关的独立预测因素。

在我们的研究中,我们证明了一些临床辅助检查的特殊性有助于指导诊断,为临床医生提供预后和治疗工具,以便选择具有最大益处的最佳管理方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f761/10572938/da60885cf3ef/diagnostics-13-03145-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f761/10572938/abeb26464779/diagnostics-13-03145-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f761/10572938/886cad80afb1/diagnostics-13-03145-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f761/10572938/c4e0527625f8/diagnostics-13-03145-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f761/10572938/da60885cf3ef/diagnostics-13-03145-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f761/10572938/abeb26464779/diagnostics-13-03145-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f761/10572938/886cad80afb1/diagnostics-13-03145-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f761/10572938/c4e0527625f8/diagnostics-13-03145-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f761/10572938/da60885cf3ef/diagnostics-13-03145-g004.jpg

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