Fishbane S, Youn S, Flaster E, Adam G, Maesaka J K
Division of Nephrology, Winthrop-University Hospital, Mineola, NY 11501, USA.
Am J Kidney Dis. 1996 May;27(5):668-72. doi: 10.1016/s0272-6386(96)90101-8.
The ankle-arm blood pressure index (AAI, ratio of ankle to arm systolic blood pressure), a simple, noninvasive, and inexpensive screening test, has recently been found to be highly predictive of subsequent mortality in several populations. The purpose of this study was to evaluate the relationship of the AAI to cardiovascular and all-cause mortality in hemodialysis patients. A cohort of 132 patients was followed for 1 year. The primary outcome measures were cardiovascular and all-cause mortality. An AAI of <0.9 was associated with a relative risk (RR) of cardiovascular mortality of 7.5, (95% CI, 2.3 to 24.8). Other predictive variables included diabetes mellitus RR 3.0, (95% CI, 1.2 to 7.3), and a history of any vascular disease RR 2.6 (95% CI, 1.0 to 7.0). An AAI of <0.9 was also predictive of all-cause mortality, RR 2.4 (95% CI, 1.2 to 4.7). Other predictive variables for all-cause mortality included older age, RR 1.4 per 10 years (95% CI, 1.0 to 2.1), decreased serum albumin RR 0.9 per 0.1 mg/dL (95% CI, 0.8 to 1.0), and diabetes mellitus RR 2.0 (95% CI, 1.0 to 3.7). Multivariate analysis showed an AAI of <0.9 and diabetes mellitus to be the only independent predictors of cardiovascular mortality, and an AAI of <0.9, older age, and a decreased serum albumin were independent predictors of all-cause mortality. In conclusion, we have found an AAI of <0.9 to be a powerful, independent predictor of mortality in hemodialysis patients.
踝臂血压指数（AAI，即踝部与臂部收缩压之比）是一项简单、无创且成本低廉的筛查测试，最近发现它能高度预测若干人群随后的死亡率。本研究的目的是评估AAI与血液透析患者心血管及全因死亡率之间的关系。对132名患者组成的队列进行了为期1年的随访。主要结局指标为心血管及全因死亡率。AAI<0.9与心血管死亡率的相对风险（RR）为7.5相关（95%置信区间，2.3至24.8）。其他预测变量包括糖尿病，RR为3.0（95%置信区间，1.2至7.3），以及任何血管疾病史，RR为2.6（95%置信区间，1.0至7.0）。AAI<0.9也可预测全因死亡率，RR为2.4（95%置信区间，1.2至4.7）。全因死亡率的其他预测变量包括年龄较大，每10岁RR为1.4（95%置信区间，1.0至2.1），血清白蛋白降低，每降低0.1mg/dL RR为0.9（95%置信区间，0.8至1.0），以及糖尿病，RR为2.0（95%置信区间，1.0至3.7）。多变量分析显示，AAI<0.9和糖尿病是心血管死亡率的仅有的独立预测因素，而AAI<0.9、年龄较大和血清白蛋白降低是全因死亡率的独立预测因素。总之，我们发现AAI<0.9是血液透析患者死亡率的一个有力的独立预测因素。
