下肢动脉缺血性患者假性高压的鉴别及临床意义

Pseudo-high blood pressure in lower limb ischemic patients

目的研究在下肢动脉缺血患者中血管压力假性升高的发生比例，及其与糖尿病的关系。方法回顾性收集自2006年3月至2008年3月在安贞医院血管外科住院或门诊就诊的182例下肢缺血患者的临床资料，将患者分为3组，不存在假性高压组；存在假性高压组（ABI〈1．3）；及存在假性高压组（ABI≥1．3）。分析其下肢无创血管检查中的踝臂指数（ankle—brachial index，ABI）与趾臂指数（toe brachial index，TBI），并与彩超，造影、MRA、及CT等结果相比较分析其ABI是否存在假性升高，检测下肢缺血的漏诊与误诊情况。结果在182例患者中，102例（56．0％）不存在假性高压，其中27．5％患有糖尿病；72例（39．6％）存在假性高压同时ABI〈1．3，其中44．4％患有糖尿病；8例（4．4％）患者存在假性高压同时ABI≥1．3，其中75％患有糖尿病。3组之间患有糖尿病的比例差异有统计学意义（均P〈0．05）。结论在患有糖尿病的下肢缺血患者中，存在假性高压的比例明显升高，应综合分析辅助检查结果来判断肢体缺血程度。

Objective To evaluate the diagnosis of and management for pseudo-high blood pressure in patients with lower limb ischemia. Methods From March 2006 to March 2007, 182 cases with lower limb ischemia were admitted, and they were divided into three groups. In group 1 pseudo-high blood pressure did not exist, in group 2, patients had pseudo-high blood pressure with ABI 〈 1.3, in group 3, patients had pseudo-high blood pressure and with ABI 1〉 1.3. ABI and TBI were compared with color Doppler, angiography, MRA and CTA. Results In all those 182 patients, there were 102 （56.0%）cases having no pseudo-high blood pressure, and 27. 5% with concomitant diabetes. Seventy-two cases（39. 6% ） had pseudo-high blood pressure （ ABI 〈 1.3 ） with 44. 4% having diabetes. Eight cases （ 4.4% ） （ ABI ≥ 1.3） manifested pseudo-high blood pressure with the ratio concomitant diabetes being 75%. Conclusions In diabetic patients with lower limb＇s ischemia there is increased ratio of pseudo-high blood pressure.