眼底动脉硬化、踝臂指数对缺血性脑卒中的诊断价值

Diagnostic value of fundus arteriosclerosis and ankle arm index in ischemic stroke

目的：研究踝臂指数、眼底动脉硬化在缺血性脑卒中的诊断价值。方法：收集2011年10月-2012年7月于本科室住院的157例缺血性脑卒中患者为实验组，同期住院的69例无缺血性卒中的患者为对照组．比较两组患者的踝臂指数、眼底动脉硬化的差异，并分析实验组各亚组患者眼底动脉硬化和踝臂指数的关系。结果：实验组患者眼底动脉硬化I级38例（24．2％）、Ⅱ级46例（29．3％）、Ⅲ级39例（24．8％）、Ⅳ级34例（21．7％），对照组中眼底动脉硬化I级31例（44．9％）、Ⅱ级19例（27．5％）、Ⅲ级10例（14．5％）、IV级9例（13．1％），两组比较差异有统计学意义，P〈0．01；实验组中各亚组患者发生眼底动脉粥样硬化病变的比例不同，差异有统计学意义，P〈0．05。实验组患者ABI值1．0～1．4为81例，ABI值〈0．9者76例；对照组分别为48例和21例，两组构成差别有统计学意义，P〈0．01；实验组患者中各亚组踝臂指数无差异，P〉0．05。结论：眼底动脉硬化、踝臂指数与缺血性卒中有明确的联系，二者均能够比较有效地预测缺血性卒中的发生。

Objective： To observe the diagnostic value of ankle-brachial index and fundus arteriosclerosis （FA） in ischemic stroke. Methods： 157 patients with ischemic cerebral stroke and 69 patients without ischemic cerebral stroke were respectively enrolled as experimental group and control group between October 2011 and July 2012. Ankle-brachial index and severity of fundus arteriosclerosis were evaluated and compared between the experimental and control groups. The relationship between of ankle arm index and fundus arteriosclerosis in each subgroups were analyzed. Results ： In the experimental group, there were 38 cases （ 24.2% ） of Grade 1, 46 （29.3%） of Grade 2, 39 （24.8%） of Grade 3 and 34 （21.70/o） of Grade 4 FA, compared with 31 cases （44. 9% ） of Grade 1, 19 （27.5%） of Grade 2, 10 （ 14.5% ） of Grade 3 and 9 （ 13.1% ） of Grade 4 FA in the control group （ P 〈 0.01 ）. The proportion of patients with each grade of FA differed among each other significantly in the experimental group （P 〈 0.05）. In the experimental group, there were 81 cases with ABI between 1.0 and 1.4, and 76 cases with ABI 〈 0.9, compared with 48 cases and 21 cases, respectively, in the control group （ P 〈 0. 01 ）. Patients with different severity of FA in the experimental group did not show significant difference in ankle-brachial index （ P 〉 0.05 ）. Conclusion： Fundus arteriosclerosis and ankle- brachial index are closely related to ischemic stroke, and both are excellent predictors for isehemic cerebral stroke.