踝臂指数评价肾功能不全患者下肢外周动脉病的研究

Study of ABI on peripheral arterial disease in patients with renal insufficiency

目的通过测量踝臂指数（ankle—brachial index，ABI）评价我国肾功能不全患者下肢外周动脉病（Pe—ripher alarterial disease．PAD）的发病情况，并对肾功能不全和PAD的共同危险因素进行评价。方法按照肌酐清除率．将2005年1月至2006年6月于北京、上海、石家庄、青岛等十几家医院住院及门诊就诊期间的6108例患者为研究对象分为两组，以肌酐清除率〈60ml·min^-1·1．73m^-2作为肾功能不全组，以肌酐清除率〉60ml·min^-1·1．73m^-2作为肾功能正常组，分别进行踝臂指数测量，以ABI≤0．9作为PAD的诊断标准，并进行资料收集和统计学处理。结果与非PAD组相比，PAD组患者肌酐清除率较低、年龄较大、男性发病率较高、糖尿病、冠心病、高血压、有吸烟史者的发病率较高，总胆固醇值较高，而在身高、体重、体重指数、收缩压、舒张压等方面无统计学意义。结论在肾功能不全患者中，PAD有非常高的发病率；ABI与肌酐清除率呈负相关，即随着肌酐清除率的下降，PAD的发病率逐渐增加。

Objective To access the prevelence of peripheral arterial disease （PAD） in hospitalized patients with chronic renal insufficiency by measuring the ankle-brachial index（ABI）,and to access the risk factors of the patients who were in chronic renal insufficiency and PAD. Methods A total of 6 108 patients were recruited and were divided into two groups according to creatinine clearance （CRCL）; an ABI less than or equal to 0.9 was considered to be indicative of PAD. Results Patients with PAD were older and had lower creatinine clearance（CRCL） ,higher total cholesterol , higher morbidity of male, diabetes mellitus, hypertension and coronary artery disease. There is no significant difference between two groups in height,weight,body-mass index（BMI）,systolic blood pressure and diastolic blood pressure. Conclusions Clinicians should be aware of the high prevalence of PAD among hospitalized patients with chronic renal insufficiency,with the decrease of the CRCL, the morbidity of PAD is gradually increased.