运动后踝臂指数对糖尿病下肢外周动脉病变的诊断价值

Value of Post-exercise Ankle-Brachial Index in Diabetic Lower Extremity Peripheral Arterial Disease

目的探讨糖尿病患者运动后测定踝臂指数(ABI)对其下肢外周动脉病变(PAD)的诊断意义和价值。方法将90例糖尿病患者按适量运动后测定ABI的不同分为PAD组(66例)和非PAD组(24例),对运动后2组患者ABI与血管造影及彩超检查的准确率及各项临床指标(年龄、BMI、血压、BUN、HbAlc、Cr、FCP、TC、UA、TG、HDL-L)进行分析比较。结果 PAD组经ABI测定均提示有动脉狭窄,经血管造影及彩超检查证实63例有动脉狭窄,诊断正确率为95.45%;非PAD组经ABI测定均提示动脉正常,经血管造影及彩超检查证实9例有动脉狭窄,诊断准确率为62.5%。2组ABI诊断准确率比较差异有统计学意义(χ2=12.57,P=0.032)。PAD组的临床各项指标均高于非PAD组,其中年龄、SBP、DBP、HbAlc、TC、UA及TG等比较差异均有统计学意义(均P<0.05)。结论运动后ABI测定是一种诊断糖尿病患者有无下肢外周动脉病变的可靠手段,可作为早期诊断PAD的常规检查方法。

Objective To explore the diagnostic significance and value of post-exercise ankle-brachial index （ABI） in diabetic lower extremity peripheral arterial disease （PAD）. Methods According to post-exercise ABI, 90 diabetes patients were divided into PAD group（n=66）and non-PAD group （n=24）. The accuracy of ABI and clinical indicators （age, BMI, blood pressure, BUN, HbAlc, Cr, FCP, TC, UA, TG and HDL-L） werer compared between the two groups after exercise. Results In PDA group, ABI showed that all patients had artery stenosis, which was confirmed by angiography and ultrasonography in 63 patients. In non-PAD group, ABI showed normal arteries in all patients, but angiography and ultrasonography showed artery stenosis in 9 patients. The correct diagnostic rate in PDA group （95.45%） was significantly higher than that in non-PAD group （62.5%） （P〈0.05）. In addition, clinical indicators in PAD group were higher than those in non-PAD group after exercise. Among them, differences in the age, SBP, DBP, HbAlc, TC, UA and TG were obvious between the two groups （P〈0.05）. Conclusion The detemination of post-exercise ABI is a reliable means and can be used as a routine examination method for early diagnosis of lower extremity PAD in patients with diabetes.