Vogt M T, Wolfson S K, Kuller L H
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA 15261.
J Clin Epidemiol. 1993 Nov;46(11):1267-76. doi: 10.1016/0895-4356(93)90091-e.
The purpose of this study was to identify the correlates of disease and mortality risk associated with the presence of stenosis in the major arterial segments of the lower limb in men and women evaluated in a peripheral vascular laboratory. A total of 326 men and 249 women had unisegmental stenosis; 312 men and 275 women had multisegmental disease; 132 men and 111 women had no apparent disease. Multivariate analysis indicated that current smoking and elevated systolic blood pressure were the key risk factors associated with isolated aortoiliac and femoropopliteal arterial disease in both men and women. A history of diabetes was significantly associated with tibioperoneal disease in men while elevated systolic blood pressure was the major correlate of distal disease in women in this patient population. The relative risk of mortality was elevated 2- to 7-fold in men and women with multi- and unisegmental disease involving the aortoiliac and femoropopliteal segments; presence of tibioperoneal disease did not significantly increase mortality relative to those who were free of disease. These results suggest that the etiology and mortality risk associated with atherosclerosis in the lower extremity may vary with the anatomic site and/or severity of the lesion.
本研究的目的是确定在周围血管实验室接受评估的男性和女性中,下肢主要动脉段狭窄与疾病及死亡风险之间的关联。共有326名男性和249名女性存在单节段狭窄;312名男性和275名女性患有多节段疾病;132名男性和111名女性无明显疾病。多变量分析表明,当前吸烟和收缩压升高是男性和女性孤立性主髂动脉和股腘动脉疾病的关键风险因素。糖尿病史与男性胫腓动脉疾病显著相关,而在该患者群体中,收缩压升高是女性远端疾病的主要相关因素。患有涉及主髂动脉和股腘动脉节段的多节段和单节段疾病的男性和女性,其死亡相对风险升高了2至7倍;与无疾病者相比,胫腓动脉疾病的存在并未显著增加死亡率。这些结果表明,下肢动脉粥样硬化的病因和死亡风险可能因病变的解剖部位和/或严重程度而异。