Nicolaides A N, Hussein M K, Szendro G, Christopoulos D, Vasdekis S, Clarke H
Irvine Laboratory for Cardiovascular Investigation and Research, Academic Surgical Unit, St. Mary's Hospital Medical School, London, United Kingdom.
J Vasc Surg. 1993 Feb;17(2):414-9. doi: 10.1067/mva.1993.37694.
Two hundred thirty-six limbs of 220 unselected patients who were admitted with venous problems (83 with ulcers) were studied with continuous-wave Doppler ultrasonography, duplex scanning, and ambulatory venous pressure measurements. Patients with evidence of deep venous disease because of reflux or obstruction in the deep veins on Doppler and duplex ultrasonic examination or with an ambulatory venous pressure greater than 45 mm Hg despite the ankle cuff had venography. One hundred fifty-three limbs had superficial venous disease (reflux in the superficial veins with competent popliteal valves), and 83 limbs had deep venous disease (popliteal reflux on duplex examination or deep venous obstruction on venography). No ulceration occurred in limbs with ambulatory venous pressure < 30 mm Hg, and there was a 100% incidence with ambulatory venous pressure > 90 mm Hg. A linear increase occurred from 14% in limbs with ambulatory venous pressure between 31 and 40 mm Hg to 100% in limbs with ambulatory venous pressure greater than 90 mm Hg (r = 0.79). In the groups studied, an increased incidence of ulceration was associated with an increase in ambulatory venous pressure irrespective of whether the venous problem was the result of superficial or deep venous disease. Ambulatory venous pressure has both diagnostic and prognostic significance in patients with venous disease.
对220例因静脉问题入院的未经过挑选的患者（其中83例患有溃疡）的236条肢体进行了研究，采用连续波多普勒超声检查、双功扫描和动态静脉压测量。对于那些在多普勒和双功超声检查中显示有深静脉反流或阻塞证据的深静脉疾病患者，或者尽管使用了踝部袖带但动态静脉压仍大于45 mmHg的患者，进行了静脉造影。153条肢体患有浅静脉疾病（浅静脉反流且腘静脉瓣膜功能正常），83条肢体患有深静脉疾病（双功检查显示腘静脉反流或静脉造影显示深静脉阻塞）。动态静脉压<30 mmHg的肢体未发生溃疡，而动态静脉压>90 mmHg的肢体溃疡发生率为100%。动态静脉压在31至40 mmHg之间的肢体溃疡发生率从14%呈线性增加至动态静脉压大于90 mmHg的肢体的100%（r = 0.79）。在所研究的组中，无论静脉问题是由浅静脉疾病还是深静脉疾病引起，溃疡发生率的增加都与动态静脉压的升高相关。动态静脉压在静脉疾病患者中具有诊断和预后意义。
