老年男性高血压病合并下肢动脉硬化症诊断方法的研究

Investigation on the clinical diagnostic method for low extre mity atherosclerosis disease in the aged male hypertensive patients

目的 :探索对下肢动脉硬化症 (lowextremityatherosclerosisdisease,LEASD)简便易行的临床诊断方法。方法 :在本院住院的患者中随机选择 6 0岁以上男性高血压病患者 6 5名 ,年龄 6 0～ 93(76 5 7± 5 89)岁 ,其中LEASD患者 38名 ,无LEASD患者 2 7名 ,对所有患者行问卷调查、体格检查、踝动脉压及趾动脉压测量 ,分别计算踝动脉压力指数 (ankle armindex ,AAI )、趾动脉压力指数 (toepressureindex ,TPI )。 结果 :LEASD组患者的AAI值、TPI值明显低于无LEASD组 ;诊断符合率当AAI≤ 0 85时为 70 0 0 % ;当TPI≤ 0 6 0时为 6 8 33% ;以有足部缺血症状、股动脉杂音、下肢动脉搏动异常中任意一项阳性为标准 ,诊断LEASD的敏感度为 89 4 7% ,特异度为 5 5 5 6 % ,诊断符合率为 75 38% ;如果结合AAI≤ 0 85、TPI≤ 0 6 0诊断LEASD的敏感性增加至 91 89%。结论 :下述指标中有任意两项为阳性者 ,高度提示LEASD。临床症状体征中一项以上阳性者 ;AAI≤ 0 85 ;TPI≤0 6 0。

Objective:To Investigate the clinical diagnos t ic method for Low Extremity Atherosclerosis Disease (LEASD) Methods : Sixty five male patients with essential hypertension were selected fr om our hospital The mean age of them was 76 6 5 9(60 93)years Thirty eigh t patients (group A) were with LEASD defined by ultrasound Doppler As matched control (group B), the other 27 cases were without LEASD All the patients were asked to fill in the same questions, the physical examinations and measurements for AAI and TPI were checked Results:1 The values of AAI and TPI in group A were much lower than those in group B ( P <0 01) 2 Th e associating rate of diagnosis for LEASD were 70% with AAI≤0 85, and 68 33% with TPI ≤0 60 respectively 3 According to any one of the positive symptoms including ischemia of feet, murmurs of femoralis and abnormal foot artery pulsa te, the sensitivity of diagnosis for LEASD was 89 47%, specificity was 55 56%, the association rate of diagnosis for LEASD were 75 38% The sensitivity was up to 91 89% when the traditional clinic diagnostic method was combined with AA I≤0 85 or TPI≤0 60 Conclusions:Based on this study, a clinic diagnostic method for LEASD was suggested: 1 Any one presents among the foot symptoms 2 AAI≤0 85 3 TPI≤0 60 The LEASD should be supposed if two of the above three indexes were positive