老年住院患者下肢动脉硬化闭塞症与心脑血管疾病的相关性

Correlation of lower extremity arteriosclerosis obliterans and cardiovascular and cerebrovascular diseases in elderly inpatients

目的探讨下肢动脉硬化闭塞症(ASO)与冠心病和脑卒中的相关性。方法回顾性分析2013年10月至2021年3月在首都医科大学附属北京世纪坛医院血管外科住院的587例老年下肢ASO患者的临床资料。调查住院患者冠心病和脑卒中患病率。分析Fontaine缺血分期、踝肱指数(ABI)与冠心病和脑卒中的相关性。采用SPSS 26.0统计软件进行数据分析。相关性分析采用Spearman相关分析。结果587例下肢ASO患者合并冠心病、脑卒中、冠心病和脑卒中患病率分别32.20%(189/587)、13.12%(77/587)及17.21%(101/587)。下肢Fontaine缺血分期与冠心病(r=7.57)及脑卒中(r=3.57)的发生呈正相关(均P<0.01)。Fontaine缺血分期与合并心脑血管疾病种类数呈正相关(r=0.13;P=0.02)。合并冠心病与无冠心病患者[0.30(0.00,0.55)和0.68(0.50,0.80)]、合并脑卒中与无脑卒中患者[0.40(0.15,0.62)和0.60(0.20,0.75)]的ABI数值比较,差异有统计学意义(均P<0.01)。ABI值与合并心脑血管疾病种类数呈负相关性(r=-0.48;P<0.01)。结论老年下肢动脉硬化闭塞症患者心脑血管疾病发生率高。下肢缺血越重,发生心脑血管疾病风险越高。

Objective To investigate the correlation of arteriosclerosis obliterans(ASO)of the lower extremity with coronary artery disease(CAD)and stroke.Methods The clinical data of 587 elderly patients with lower extremity ASO hospitalized in our hospital from October 2013 to March 2021 were collected and analyzed retrospectively.Their incidences of CAD and stroke were investigated.The correlations of Fontaine ischemic stage and ankle brachial index(ABI)with CAD and stroke were analyzed with Spearman correlation analysis.SPSS statistics 26.0 was employed for statistical analyses.Results The incidence rates of CAD,stroke,and CAD complicated with stroke were 32.20%(189/587),13.12%(77/587)and 17.21%(101/587),respectively in the 587 patients.The Fontaine ischemic stage in the lower extremity was positively correlated with the occurrence of CAD(r=7.57,P<0.01)and stroke(r=3.57,P<0.01),and number of cardiovascular and cerebrovascular diseases(r=0.13,P=0.02).There was significant difference in ABI between the patients with CAD and those without[0.30(0.00,0.55)vs 0.68(0.50,0.80)],and those with stroke and without[0.40(0.15,0.62)vs 0.60(0.20,0.75)](both P<0.01).ABI value had a negative correlation with the number of cardiovascular and cerebrovascular diseases(r=-0.48,P<0.01).Conclusion The incidence of cardio-cerebrovascular diseases is quite high in the elderly patients with lower extremity ASO.The more severe the lower extremity ischemia is,the higher risk for cardiovascular and cerebrovascular diseases.