Zhou Quan, Huang Sufang
Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 430030 Wuhan, Hubei, China.
Rev Cardiovasc Med. 2023 Jan 4;24(1):9. doi: 10.31083/j.rcm2401009. eCollection 2023 Jan.
Abnormal inter arm systolic blood pressure, inter leg systolic blood pressure and ankle brachial index (ABI) are related to vascular diseases. Our aim was to evaluate the correlation of inter arm systolic blood pressure difference (IASBPD), inter leg systolic blood pressure difference (ILSBPD), and ABI with acute aortic dissection (AAD) and their role in predicting AAD.
In this prospective case-control study, 180 patients with AAD admitted to the emergency department were prospectively and consecutively collected in Tongji Hospital from October 2019 to December 2020. 180 healthy people matched by sex, age and BMI served as control group. All participants were adults over 18 years of age who underwent four-limb blood pressure measurements. IASBPD, ILSBPD and ABI were compared between the two groups and their associations with AAD were analyzed.
A total of 360 patients (180 cases and 180 controls) were analyzed. In case group IASBPD was larger [(15.23 16.15) mm Hg (4.19 3.63) mm Hg] and ILSBPD was larger (13.00 mm Hg 5.70 mm Hg). ABI was smaller [(0.98 0.24) (1.12 0.09)], and the difference was statistically significant (all 0.05). According to the receiver operating characteristic curve (ROC), IASBPD 10 mm Hg (Sen 61.7%, Spe 88.9%), ILSBPD 13 mm Hg (Sen 50.6%, Spe 80.6%) and ABI 0.9 (Sen 53.3%, Spe 87.2%), showed significant correlation with AAD (all 0.001).
Compared with healthy people, IASBPD and ILSBPD levels were higher and ABI levels were lower in patients with AAD. IASBPD 10 mm Hg and ILSBPD 13 mm Hg can be used as indicators for early screening of AAD, and IASBPD 10 mm Hg has better predictive value for the occurrence of AAD. In patients with typical chest pain, attention needs to be paid to measuring blood pressure in the extremities.
双臂收缩压、双腿收缩压及踝臂指数（ABI）异常与血管疾病相关。我们的目的是评估双臂收缩压差（IASBPD）、双腿收缩压差（ILSBPD）及ABI与急性主动脉夹层（AAD）的相关性及其在预测AAD中的作用。
在这项前瞻性病例对照研究中，2019年10月至2020年12月在同济医院前瞻性连续收集180例急诊收治的AAD患者。180名性别、年龄和BMI匹配的健康人作为对照组。所有参与者均为18岁以上的成年人，均接受了四肢血压测量。比较两组间的IASBPD、ILSBPD及ABI，并分析它们与AAD的相关性。
共分析360例患者（180例病例和180例对照）。病例组IASBPD更大[（15.23±16.15）mmHg对（4.19±3.63）mmHg]，ILSBPD更大（13.00mmHg对5.70mmHg）。ABI更小[（0.98±0.24）对（1.12±0.09）]，差异有统计学意义（均P<0.05）。根据受试者工作特征曲线（ROC），IASBPD≥10mmHg（敏感度61.7%，特异度88.9%）、ILSBPD≥13mmHg（敏感度50.6%，特异度80.6%）及ABI≤0.9（敏感度53.3%，特异度87.2%）与AAD显著相关（均P<0.001）。
与健康人相比，AAD患者的IASBPD和ILSBPD水平更高，ABI水平更低。IASBPD≥10mmHg和ILSBPD≥13mmHg可作为AAD早期筛查指标，且IASBPD≥10mmHg对AAD发生有更好的预测价值。对于有典型胸痛的患者，需注意测量四肢血压。
