踝肱压力指数在诊断糖尿病女性冠心病的应用

Importance of ankle-brachial pressure index in the diagnosis of coronary artery disease in women with diabetes mellitus

目的女性冠状动脉疾病(CAD)的临床症状往往不定,尤其对患有糖尿病(DM)的女性,因此有必要通过简单的诊断测试,来确定高危糖尿病(DM)女性是否有患CAD的风险。方法本院疑似冠心病患者80例,其中DM患者34例。分别对患者行运动负荷心肌灌注成像和臂部、踝关节血压测量,以检测患者缺血性总灌注缺损大小(TPD)和踝肱压力指数(ABI)。结果缺血性TPD在男、女患者间比较无明显差异,而DM患者缺血性TPD明显大于无糖尿病患者;缺血性TPD在DM男、女患者中比较无明显差异;然而,ABI<0.9的DM女性比ABI≥0.9的DM女性有较高的缺血性TPD,ABI值在男性中间比较无差异。结论 ABI评估DM无症状女性CAD患者的发病是可行的,检测结果显示缺血性TPD>10%是冠状动脉血运重建的一个显像指标。

Objective Clinical symptoms of coronary artery disease （CAD） are often atypi- cal in women, particularly in those with diabetes mellitus （DM）. Therefore, a simple diagnostic test to identify high- risk women with DM who are likely to have CAD is important. Methods There were a total of 80 patients with suspected CAD, in which 34 with DM. Stress myocardial per- fusion imaging and simultaneous brachial and ankle blood pressure measurements were performed to obtain ischemic total perfusion deficit （TPD） and ankle- braehial pressure index （ABI）, respective- ly. Results Ischemic TPD was not significantly different between men and women, whereas is- chemic TPD was significantly greater in diabetic patients than in non - diabetic patients. In diabetic patients, ischemic TPD was not significantly different between men and women. However, women with ABI 〈 0.9 showed significantly greater ischemic TPD than those with ABI≥0.9, whereas no difference in ABI was observed in men. Conclusion ABI is feasible for evaluating CAD attack in asymptomatic women with DM, and the ischemic TPD〉 10 % is regarded as a scintigraphic indica- tor for coronary revascularization.