踝/肱动脉压比值在糖尿病周围动脉病变诊断中的应用价值

摘要

目的评价踝/肱动脉压比值（ABI）在糖尿病周围动脉病变（PAD）诊断中的价值，并探讨其在临床的适用性。方法对符合入选标准的88例2型糖尿病患者进行间歇性跛行问卷调查、足部动脉触诊、下肢动脉彩色多普勒超声检查以及ABI检测，以多普勒超声诊断结果为标准，计算间歇性跛行问卷、足部动脉触诊、ABI≤0.9诊断PAD的敏感度、特异度、阳性预测值、阴性预测值、准确度以及Kappa值（κ值）。结果ABI≤0.9诊断糖尿病PAD的敏感度、特异度和准确度分别为75.00%、96.80%和91.12%，与彩色多普勒超声检查之间一致性极好（κ＝0.76±0.06）。结论多普勒ABI检测操作简便、无创，可用于门诊及住院糖尿病患者无症状PAD初步筛查以及流行病学调查。%Objective To evaluate the efficacy of ankle-brachial index(ABI) in the diagnosis of diabetic peripheral arterial disease(PAD).Methods 88 patients with type 2 diabetes underwent the 4 simple tests:Edinburgh Claudication Questionnaire evaluation,foot arterial palpation,lower extremity artery with color Doppler ultrasonography and ABI examination.Using the results of Color Doppler Ultrasonography as criteria,the sensitivi-ty,speciifcity,positive and negative predictive values,accuracy and kappa values of these tests were analyzed.Results The sensitivity,speciifcity and accuracy of ABI≤0.9 were 75.00%,96.80%and 91.12%,respectively.ABI≤0.9 and Color Doppler Ultrasonography showed good agree ment in the diagnosis of diabetic peripheral neuropathy(κ=0.76±0.06).Conclusion ABI is a non-invasive and reliable tool for screening asymptomatic diabetic PAD in both diabetes clinics and epidemiological surveys.