趾臂指数在原发性高血压下肢动脉疾病中的应用

Application of toe-brachial index in predicting lower extremity arterial disease in patients with essential hypertension

目的:分析原发性高血压患者趾臂指数(TBI)在下肢动脉疾病(LEAD)病变中的检测意义。方法:回顾性分析2018年1月至2019年4月在广西医科大学第一附属医院高血压病区住院的原发性高血压患者的临床资料,根据下肢动脉内膜中层厚度(IMT),将患者分为正常组(IMT≤1 mm)和病变组(IMT>1 mm)。比较两组性别、年龄、体重指数(Ibm)、平均动脉压(MAP)、趾血压、TBI、踝臂指数(ABI)、C反应蛋白(CRP)及糖化血红蛋白水平,采用Bivariate相关性分析法对TBI与其他高血压指标进行相关性分析。结果:病变组患者年龄、Ibm、MAP及糖化血红蛋白水平均高于正常组,而TBI低于正常组(均P<0.05);两组CRP和ABI比较,差异无计学意义(P>0.05)。TBI与Ibm、MAP、糖化血红蛋白、IMT呈负相关关系(均P<0.05),与趾血压呈正相关关系(P<0.05)。结论:TBI可作为初步筛高血压患者LEAD的指标之一,在ABI正常时可做TBI检测以明确有无LEAD。

Objective:To analyze the detection significance of toe-brachial index(TBI)in patients with essential hypertension and lower extremity arterial disease(LEAD).Methods:The clinical data of patients with essential hypertension in our hospital from January 20 to April 2019 were retrospectively studied.According to the intima-media thickness(IMT)of the lower extremity arteries,the patients were divided into control group(IMT≤1 mm)and lesion group(IMT>1 mm).Gender,age,body mass index,mean arterial pressure(MAP),toe blood pressure,TBI,ankle-brachial index(ABI),C-reactive protein(CRP)and glycosylated hemoglobin levels were compared.Bivariate correlation analysis was used to analyze the correlation between TBI and other hypertensive indexes.Results:There was no difference in the gender between the two groups(P>0.05).The age,body mass index,MAP and glycosylated hemoglobin level of the lesion group were higher than those of the control group,while the TBI was lower(P<0.05).There was no significant difference in CRP and ABI between the two groups(P>0.05).TBI was negatively correlated with body mass index,MAP,glycosylated hemoglobin and IMT,but negatively correlated with toe blood pressure(P<0.05).Conclusion:TBI can be used as an index for LEAD in patients with hypertension,and the detection of TBI can identify LEAD when ABI is normal.