【摘要】 目的探讨踝肱指数(ABI)、趾肱指数(TBI)在下肢动脉疾病诊断中的应用价值及其影响因素。方法对2010年7月-2011年2月收治的402例糖尿病和(或)高血压患者的800条下肢行ABI和TBI检查,根据ABI结果分为狭窄组(ABI<0.9),正常组(0.9≤ABI<1.3)和钙化组(ABI≥1.3),根据TBI结果分为狭窄组(TBI<0.7)和正常组(TBI≥0.7),分析ABI和TBI的相关性,比较各组之间年龄、肥胖参数、生化指标等因素的差异,并进一步分析超敏C反应蛋白(hs-CRP)对ABI和TBI的影响。结果仅当ABI<0.9时ABI与TBI显著相关(r=0.826,P<0.01)。根据ABI值大小分组后比较显示:狭窄组年龄、hs-CRP显著高于正常组和钙化组(P<0.01)。根据TBI值大小分组后比较显示:狭窄组年龄、收缩压、hs-CRP显著高于正常组(P<0.01或P<0.05)。hs-CRP正常者ABI、TBI显著高于hs-CRP增高者(P<0.05)。结论 hs-CRP可能在外周动脉粥样硬化的发生发展中起重要作用。测定ABI和TBI并结合hs-CRP有利于提高下肢动脉疾病的早期诊断率。更多还原

【Abstract】 Objective To investigate the clinical application and its influencing factors of ankle-brachial index(ABI) and toe-brachial index(TBI) in the diagnosis of arterial disease of lower extremity.Methods ABI and TBI were measured in 800 limbs of 402 patients with diabetes and/or hypertension hospitalized from July 2010 to February 2011.The patients were divided into narrow group(ABI<0.9),normal group(0.9≤ABI<1.3),and calcification group(ABI≥1.3) according to the value of ABI,and also into narrow group(TBI<0.7) and normal group(TBI≥0.7) according to the value of TBI.The correlation of ABI with TBI was analyzed,and the differences in age,obesity parameters,biochemical indicators and other factors were compared between the groups.Influence of high-sensitivity C-reactive protein(hs-CRP) on ABI and TBI was further analyzed.Results Only when ABI<0.9,ABI and TBI have significant correlation(r=0.826,P<0.01).When the group comparison based on ABI values,it was shown that the age and hs-CRP were significantly higher in the narrow group than in the normal group and calcification group(P<0.01).The comparison between groups based on TBI values indicated that the age,systolic blood pressure and hs-CRP in the narrow group were significantly higher than those in the normal group(P<0.01 or P<0.05).ABI and TBI in the normal hs-CRP group were significantly higher than those in high hs-CRP group(P<0.05).Conclusion Hs-CRP may play an important role in the development and progression in peripheral arterial atherosclerosis.Therefore,ABI and TBI measurements in combination with hsCRP level can improve early diagnosis of arterial disease of lower extremity.更多还原