Boccalon H, Lehert P
Service d'Angiologie, CHU Rangueil, Toulouse.
J Mal Vasc. 1995;20(1):28-37.
Atherosclerotic lower-limb arteriopathy is a serious disease. Its prevalence often underestimated when relying only on questioning the patient. A simple early detection method is the systolic index, i.e. the ratio of systolic ankle over brachial pressure. This ratio should normally be greater than 0.9. Lower values indicate detectable arterial obstruction as revealed by reduced peripheral perfusion. Under 0.75 patients are considered as suffering from peripheral vascular disease and require further investigations and specialist opinion. With an index between 0.75 and 0.90 patients are classified as stage I or II of the disease. In a survey by 180 General Practitioners, which were trained by angiologists to measure ankle pressure, more than 1,400 patients, between 40 and 75-years old, with at least one vascular risk factor (hypertension, diabetes, lipids, tobacco) were selected. Tobacco was the most prevalent vascular risk factor, then diabetes (particularly in men). 23.8% of patients recorded values between 0.90 and 0.75 and thus suffering from peripheral vascular disease (certainly age dependent). Clinically absent pulses at the posterior tibial and the dorsalis pedis artery were found is 19 and 27% of patients respectively. Most of the patients received a pharmacological substance allowing to check this index sensitivity. Thus systolic index is a simple low cost method for early detection and care and more general utilisation is proposed.
动脉粥样硬化性下肢动脉病是一种严重疾病。仅依靠询问患者时，其患病率常被低估。一种简单的早期检测方法是收缩压指数，即踝部收缩压与肱动脉收缩压之比。该比值正常情况下应大于0.9。较低的值表明可检测到动脉阻塞，表现为外周灌注减少。低于0.75时，患者被认为患有外周血管疾病，需要进一步检查并征求专家意见。指数在0.75至0.90之间的患者被归类为疾病的I期或II期。在一项由180名全科医生参与的调查中，这些医生接受了血管造影专家的培训以测量踝部压力，选取了1400多名40至75岁、至少有一种血管危险因素（高血压、糖尿病、血脂异常、吸烟）的患者。吸烟是最常见的血管危险因素，其次是糖尿病（尤其是在男性中）。23.8%的患者记录值在0.90至0.75之间，因此患有外周血管疾病（肯定与年龄有关）。分别在19%和27%的患者中发现胫后动脉和足背动脉临床上无脉搏。大多数患者接受了一种可用于检查该指数敏感性的药物。因此，收缩压指数是一种用于早期检测和护理的简单低成本方法，建议更广泛地应用。
