老年人周围动脉疾病与颈动脉内膜中层厚度的关系以及危险因素分析

Relationship between peripheral artery disease and carotid intima-media thickness and risk factors of PAD in elderly patients

目的探讨老年人周围动脉疾病(PAD)与颈动脉内膜中层厚度(I MT)的关系,分析其危险因素。方法测定了126例老年人的踝肱指数(ABI),≤0.9定义为PAD。同时测定I MT和C反应蛋白(CRP)。结果PAD发生率为19.8%(70～79岁,80～89岁和≥90岁年龄组的发生率分别为16.3%,20.6%和33.3%)。I MT≥1.5 mm组的ABI显著低于其他各组(P<0.05)。PAD患者的I MT(1.52±0.34)mm较无PAD者(1.04±0.15)mm明显增加(P<0.01)。PAD患者的CRP(中位数5.00 mmol/L)较无PAD者(中位数2.22 mmol/L)升高(P<0.05)。PAD与I MT相关(r=0.649,P<0.01)。Logistic回归分析显示,糖尿病、高血压、低的高密度脂蛋白和年龄是PAD的危险因素。结论老年人PAD发病率较高,随年龄增加患病率增加。I MT与PAD密切相关,可以作为判断PAD的指标之一。糖尿病、高血压、低的高密度脂蛋白和年龄是PAD的危险因素。PAD患者的心血管事件风险明显增加。

Objective To explore the relationship of peripheral artery disease （PAD） and carotid intima-media thickness （IMT）and analyze the risk factors of PAD in the elderly. Methods The ankle brachial index （ABI） of left and right limb was measured in 126 elderly patients, and PAD was diagnosed as ABI≤0.9. IMT and C-reactive protein （CRP） was determined as well. Results The total incidence of PAD in these elderly patients was 19.8%. The incidences of PAD were 16.3%,20. 6% and 33.3% ,respectively,for the groups of 70～79 years old, 80～89 years old,and ≥90 years old. ABIs of two limbs in group of IMT ≥1.5 mrn were （0.87±0. 18） ram, （0. 83±0.18） ram,respectively, which were obviously higher than those in the other groups （P〈0.05）. IMT of patients with PAD was remarkably thicker than that of those without PAD [-（1.52±0. 34） vs. （1.04 ±0.15） ram, P〈0. 01]. CRP of patients with PAD（mean 5.00 retool/L） was markedly increased compared with that of patients without PAD （mean 2.22mmol/L, P〈0.05）. IMT was negatively correlated with PAD （r=-0. 649, P〈0. 01）. Logistic regression analysis showed that diabetes, hypertension, lower HDL and age were the risk factors of PAD. Conclusion The incidence of PAD is high in the elderly, and increases along with age. Diabetes, hypertension, lower HDL and age are the risk factors of PAD. The cardiovascular risk of the patients with PAD is obviously increased.