摘要
目的:评估多功能周围血管检查仪诊断下肢血管病变的临床价值。方法:选择2005-04/07连续3个月在解放军总医院老年内分泌科住院的老年男性2型糖尿病患者40例。其中伴有冠状动脉粥样硬化性心脏病者23例,高血压者31例,血脂异常者14例;脑血管病者4例;吸烟及既往有吸烟史者21例,有间歇跛行症状者6例,有足背或胫后动脉搏动减弱26例,足背或胫后动脉搏动消失者8例。先后以彩色多普勒超声(彩超)及多功能周围血管检查仪检查评估有无下肢血管病变。以彩超为诊断标准,评价踝肱指数及多功能周围血管检查仪诊断下肢血管病变的相关诊断指标。结果:40例患者均进入结果分析。①彩超诊断有动脉粥样硬化改变的肢体占90%,其中动脉粥样硬化斑块突起及管腔狭窄≥50%的肢体占40%。②多功能周围血管检查仪诊断有下肢血管病变的肢体占35%,其中踝肱指数≤1.0的肢体占27.5%,踝肱指数≤0.9的肢体占22.5%。③以彩超诊断下肢血管病变为标准,多功能周围血管检查仪的敏感性81.25%,特异性95.83%,阳性预测值92.86%,阴性预测值88.46%,诊断符合率90%。④彩超诊断下肢血管病变组踝肱指数值明显低于非病变组,两者差异具有显著性意义。结论:彩超对下肢血管病变的早期诊断价值较高。以彩超相应标准为下肢血管病变诊断依据,多功能周围血管检查仪确诊率高。多功能周围血管检查仪综合分析较单独应用踝肱指数诊断下肢血管病变的准确性高。
AIM： To evaluate the clinical value of peripheral artery disease （PAD） diagnosed with personal vascular laboratory （PVL）.
METHODS： Totally 40 senior male subjects with type 2 diabetes mellitus who hospitalized for 3 months continuously at Department of Geriatric Endocrinology, General Hospital of Chinese PLA from April to July 2005 were enrolled, Of them, there were 23 subjects accompanied with coronary atherosclerotic heart disease, 31 subjects with hypertension, 14 subjects with abnormal blood fat, 4 subjects with cerebrovascular disease, 21 subjects smoking or with history of smoking, 6 subjects with intermittent claudication, 26 subjects with decrease of arteriopalmus of dorsum pedis or posterior tibial artery and 8 subjects with disappearance of arteriopalmus of dorsum pedis or posterior tibial artery, PAD was estimated by Color Doppler ultrasound （CDU） and PVL. Taking CDU diagnostic standard as definition, the related diagnostic criterions of PAD were assessed by the two methods of ankle brachial index （ABI） and PVL.
RESULTS： A total of 40 subjects were involved in the result analysis, ① 90% of the lower limes had the arteriosclerosis change by CDU, 40% of them had convex plaques and vascular stenosis, which was more than 50%, ②35% of the lower limes had PAD by PVL, 27.5% of their ABI were less than 1.0 and 22.5% of them were less than 0.9, ③Using the criterion of PAD by CDU, the sensitivity of PVL was 81.25%, the specificity was 95.83% ,the positive predictive value was 92.86% ,the negative predictive value was 88.46% and the overall accuracy was 90%; ④The ABI data from the group with PAD were obviously lower than that from the group without PAD, and the difference between these data of the two groups was significant.
CONCLUSION： The early diagnostic value of CDU to PAD is high, The diagnostic value of PVL is high as compared with the criterion of PAD by CDU, The diagnostic accuracy to PAD with the synthesis analysis by PVL is higher than that only with ABI.
出处
《中国临床康复》
CSCD
北大核心
2006年第24期111-113,共3页
Chinese Journal of Clinical Rehabilitation
