Background: In new outpatients, blood pressure should be measured in both arms. A previous study reported that an inter-arm systolic blood pressure difference (ΔSBP) of ≥10 mm Hg is associated with an increased risk...Background: In new outpatients, blood pressure should be measured in both arms. A previous study reported that an inter-arm systolic blood pressure difference (ΔSBP) of ≥10 mm Hg is associated with an increased risk of mortality. Aim: The aim was to identify the associations with absolute values of ΔSBP (|ΔSBP|) ≥10 mm Hg. Subjects and Methods: This study included 2481 patients. Patients with a body mass index ≥25 kg/m<sup>2</sup> were defined as obese. The group of A was defined as following: ankle-brachial index (ABI) was <0.9 or ≥1.3. ΔSBP was expressed as right arm BP minus left arm BP. |ΔSBP| ≥10 mm Hg were analyzed using multivariate logistic analysis. Results: |ΔSBP| ≥10 mm Hg was found in 6.0% of patients and |ΔSBP| < 5 mm Hg in 80.4%. In multivariate analysis, the odds ratios (ORs) of the associations with |ΔSBP| ≥10 mm Hg were significantly associated with abnormal ABI and obesity regardless of sex and age. Moreover, the OR of the combined effects of abnormal ABI and obesity was higher than that of abnormal ABI and obesity alone. Conclusion: |ΔSBP| ≥10 mm Hg was associated with abnormal ABI and obesity. In a primary care setting, blood pressure should be actively measured in both arms. This study suggests that the associations with |ΔSBP| ≥10 mm Hg may be a useful part of screening for abnormal ABI.展开更多
Background: Peripheral artery disease (PAD) is the least recognized form of atherosclerosis and may even result in amputation if the diagnosis is delayed. Manual pulse palpation is the traditional way to diagnose PAD....Background: Peripheral artery disease (PAD) is the least recognized form of atherosclerosis and may even result in amputation if the diagnosis is delayed. Manual pulse palpation is the traditional way to diagnose PAD. Doppler ultrasonographic measurement of ankle-brachial index (ABI) is the gold standard diagnosing method but requires training and is not necessarily available as an outpatient procedure. Using automated oscillometric blood pressure devices has been suggested as an easier method for measuring the ABI. Methods: A single observer palpated the arterial dorsalis pedis, examined hand joints and measured the ABI of one hundred diabetic patients using both Doppler and oscillometric methods. The purpose of this study was to compare the oscillometric method and the manual diagnosing methods to the gold standard method of using a hand held Doppler device for measuring the ABI and detecting PAD. Results: ABI was abnormal in 24 patients (24%) (22 males, 2 females) when measured with the Doppler method. Of these 24 patients, the oscillometric method would have missed 12 giving 12 false negatives. We found that the sensitivity of the oscillometric method was 50.0% and specificity 90.8%. Clinical examination with palpation of ADP combined with limited joint mobility (LJM) scoring would have missed only four cases. Conclusions: Although the oscillometric method is easy and accessible, it is not sensitive enough to be used as the only method in measuring ABI. The simple and inexpensive ADP pulse palpation combined with testing for LMJ was able to find 20 of the 24 (83%) patients with an abnormal ABI measured by Doppler stethoscope.展开更多
Background Numerous trials showed that blood pressure variability （BPV） plays an important role in triggering acute cardiovascular and cerebrovascular events. However, few studies have clarified the relationship bet...Background Numerous trials showed that blood pressure variability （BPV） plays an important role in triggering acute cardiovascular and cerebrovascular events. However, few studies have clarified the relationship between the coronary artery atherosclerosis severity with BVP and ankle-brachial index （ABI）. There are few studies in which have investigated BPV, ankle-brachial index （ABI）, brachial ankle pulse wave velelocity （baPWV） and severity of coronary angiography（ CAG ） at the same time. Methods Totally 188 hypertensive patients from January 2012 to March 2015 were enrolled in this study. All the cases underwent 24h ambulatory blood pressure monitoring （ABPM）, CAG and ABI. The extent of coronary artery disease was assessed by the Gensini score system. The subjects were divided into four groups： A（ Gensini score=0）, B（Gensini score≤20）, C（ 20〈Gensini score 〈50）, D（Gensini score≥50）. Pearson correlation and stepwise multiple regression were used for analyses. Results Compared with the A and B group, most of blood pressure standard deviation and average ABI of D group were higher （P 〈 0.05）. Correlation analysis indicated that Gensini score was positively correlated with 24h systolic blood pressure standard deviation （24hsbpsd）, day systolic blood pressure standard deviation （dsbpsd） and night systolic blood pressure standard deviation（nsbpsd）; But it was reversely correlated with ABI. ABI was reversely correlated with 24hsbpsd and nsbpsd. Gensini score was positively correlated with 24hsbpsd（P=0.02） and dsbpsd（P〈0.05）, while reversely correlated with ABI（P〈0.05） by multiple linear stepwise regression analysis. Conclusion BPV and ABI are closely related to severity of coronary artery atherosclerosis. They are predictors in patients with coronary artery disease with hypertension.展开更多
目的探讨红细胞分布宽度(RDW)、血小板与淋巴细胞比值(PLR)、动脉血氧分压(PaO2)及动脉血二氧化碳分压(PaCO2)在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压(PH)中的临床意义。方法选取2017年2月至2019年2月郑州大学第一附属医...目的探讨红细胞分布宽度(RDW)、血小板与淋巴细胞比值(PLR)、动脉血氧分压(PaO2)及动脉血二氧化碳分压(PaCO2)在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压(PH)中的临床意义。方法选取2017年2月至2019年2月郑州大学第一附属医院收治的140例AECOPD患者为研究对象。根据心脏彩色多普勒超声所测得的肺动脉收缩压(SPAP),将入选患者分为A组(SPAP<40 mm Hg)80例和B组(SPAP≥40 mm Hg)60例,B组又分为轻度PH组42例和中重度PH组18例。所有入选患者于入院后24 h内留取静脉血标本,应用血细胞分析仪测定RDW、PLR值;于入院后2 h内静卧不吸氧或者停止吸氧30 min后,抽取桡动脉血行动脉血气分析,记录PaO2、PaCO2值,并比较不同组别间的RDW、PLR、PaO2、PaCO2水平及各指标间的相关性。结果 B组的RDW、PLR、PaCO2高于A组,差异有统计学意义(均P<0.05);B组的PaO2低于A组,差异有统计学意义(P<0.05)。中重度PH组血清RDW、PLR、PaCO2高于轻度PH组,中重度PH组PaO2低于轻度PH组,差异有统计学意义(均P<0.05)。相关性分析结果示,SPAP与RDW(r=0.437,P<0.001)、PLR(r=0.590,P<0.001)、PaCO2(r=0.400,P=0.002)之间存在正相关关系;SPAP与PaO2(r=-0.450,P<0.001)间存在负相关关系。结论 RDW、PLR、PaO2、PaCO2与AECOPD患者合并PH的发生及病情严重程度相关,为及早明确AECOPD患者合并PH及合并PH的病情严重程度提供了简便快捷的检测指标。展开更多
文摘Background: In new outpatients, blood pressure should be measured in both arms. A previous study reported that an inter-arm systolic blood pressure difference (ΔSBP) of ≥10 mm Hg is associated with an increased risk of mortality. Aim: The aim was to identify the associations with absolute values of ΔSBP (|ΔSBP|) ≥10 mm Hg. Subjects and Methods: This study included 2481 patients. Patients with a body mass index ≥25 kg/m<sup>2</sup> were defined as obese. The group of A was defined as following: ankle-brachial index (ABI) was <0.9 or ≥1.3. ΔSBP was expressed as right arm BP minus left arm BP. |ΔSBP| ≥10 mm Hg were analyzed using multivariate logistic analysis. Results: |ΔSBP| ≥10 mm Hg was found in 6.0% of patients and |ΔSBP| < 5 mm Hg in 80.4%. In multivariate analysis, the odds ratios (ORs) of the associations with |ΔSBP| ≥10 mm Hg were significantly associated with abnormal ABI and obesity regardless of sex and age. Moreover, the OR of the combined effects of abnormal ABI and obesity was higher than that of abnormal ABI and obesity alone. Conclusion: |ΔSBP| ≥10 mm Hg was associated with abnormal ABI and obesity. In a primary care setting, blood pressure should be actively measured in both arms. This study suggests that the associations with |ΔSBP| ≥10 mm Hg may be a useful part of screening for abnormal ABI.
文摘Background: Peripheral artery disease (PAD) is the least recognized form of atherosclerosis and may even result in amputation if the diagnosis is delayed. Manual pulse palpation is the traditional way to diagnose PAD. Doppler ultrasonographic measurement of ankle-brachial index (ABI) is the gold standard diagnosing method but requires training and is not necessarily available as an outpatient procedure. Using automated oscillometric blood pressure devices has been suggested as an easier method for measuring the ABI. Methods: A single observer palpated the arterial dorsalis pedis, examined hand joints and measured the ABI of one hundred diabetic patients using both Doppler and oscillometric methods. The purpose of this study was to compare the oscillometric method and the manual diagnosing methods to the gold standard method of using a hand held Doppler device for measuring the ABI and detecting PAD. Results: ABI was abnormal in 24 patients (24%) (22 males, 2 females) when measured with the Doppler method. Of these 24 patients, the oscillometric method would have missed 12 giving 12 false negatives. We found that the sensitivity of the oscillometric method was 50.0% and specificity 90.8%. Clinical examination with palpation of ADP combined with limited joint mobility (LJM) scoring would have missed only four cases. Conclusions: Although the oscillometric method is easy and accessible, it is not sensitive enough to be used as the only method in measuring ABI. The simple and inexpensive ADP pulse palpation combined with testing for LMJ was able to find 20 of the 24 (83%) patients with an abnormal ABI measured by Doppler stethoscope.
文摘Background Numerous trials showed that blood pressure variability （BPV） plays an important role in triggering acute cardiovascular and cerebrovascular events. However, few studies have clarified the relationship between the coronary artery atherosclerosis severity with BVP and ankle-brachial index （ABI）. There are few studies in which have investigated BPV, ankle-brachial index （ABI）, brachial ankle pulse wave velelocity （baPWV） and severity of coronary angiography（ CAG ） at the same time. Methods Totally 188 hypertensive patients from January 2012 to March 2015 were enrolled in this study. All the cases underwent 24h ambulatory blood pressure monitoring （ABPM）, CAG and ABI. The extent of coronary artery disease was assessed by the Gensini score system. The subjects were divided into four groups： A（ Gensini score=0）, B（Gensini score≤20）, C（ 20〈Gensini score 〈50）, D（Gensini score≥50）. Pearson correlation and stepwise multiple regression were used for analyses. Results Compared with the A and B group, most of blood pressure standard deviation and average ABI of D group were higher （P 〈 0.05）. Correlation analysis indicated that Gensini score was positively correlated with 24h systolic blood pressure standard deviation （24hsbpsd）, day systolic blood pressure standard deviation （dsbpsd） and night systolic blood pressure standard deviation（nsbpsd）; But it was reversely correlated with ABI. ABI was reversely correlated with 24hsbpsd and nsbpsd. Gensini score was positively correlated with 24hsbpsd（P=0.02） and dsbpsd（P〈0.05）, while reversely correlated with ABI（P〈0.05） by multiple linear stepwise regression analysis. Conclusion BPV and ABI are closely related to severity of coronary artery atherosclerosis. They are predictors in patients with coronary artery disease with hypertension.
文摘目的探讨红细胞分布宽度(RDW)、血小板与淋巴细胞比值(PLR)、动脉血氧分压(PaO2)及动脉血二氧化碳分压(PaCO2)在慢性阻塞性肺疾病急性加重期(AECOPD)合并肺动脉高压(PH)中的临床意义。方法选取2017年2月至2019年2月郑州大学第一附属医院收治的140例AECOPD患者为研究对象。根据心脏彩色多普勒超声所测得的肺动脉收缩压(SPAP),将入选患者分为A组(SPAP<40 mm Hg)80例和B组(SPAP≥40 mm Hg)60例,B组又分为轻度PH组42例和中重度PH组18例。所有入选患者于入院后24 h内留取静脉血标本,应用血细胞分析仪测定RDW、PLR值;于入院后2 h内静卧不吸氧或者停止吸氧30 min后,抽取桡动脉血行动脉血气分析,记录PaO2、PaCO2值,并比较不同组别间的RDW、PLR、PaO2、PaCO2水平及各指标间的相关性。结果 B组的RDW、PLR、PaCO2高于A组,差异有统计学意义(均P<0.05);B组的PaO2低于A组,差异有统计学意义(P<0.05)。中重度PH组血清RDW、PLR、PaCO2高于轻度PH组,中重度PH组PaO2低于轻度PH组,差异有统计学意义(均P<0.05)。相关性分析结果示,SPAP与RDW(r=0.437,P<0.001)、PLR(r=0.590,P<0.001)、PaCO2(r=0.400,P=0.002)之间存在正相关关系;SPAP与PaO2(r=-0.450,P<0.001)间存在负相关关系。结论 RDW、PLR、PaO2、PaCO2与AECOPD患者合并PH的发生及病情严重程度相关,为及早明确AECOPD患者合并PH及合并PH的病情严重程度提供了简便快捷的检测指标。
