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題名 | Ankle-brachial Index Measured by an Automated Oscillometric Method as a Predictor of Cardiovascular Events in Patients with Coronary Artery Disease=以自動化脈衝式的方法所測得的踝臂血壓比可當做冠狀動脈病人心血管不良事件的指標 |
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作者 | 蘇河名; 溫文才; 賴文德; 李坤泰; 朱志生; 林宗憲; 許勝雄; | 書刊名 | Acta Cardiologica Sinica |
卷期 | 21:1 2005.03[民94.03] |
頁次 | 頁13-18 |
分類號 | 415.3161 |
關鍵詞 | 踝臂血壓化; 冠狀動脈疾病; 周邊動脈阻塞性病變; 心血管不良事件; Ankle-brachial index; Coronary artery disease; Peripheral arterial occlusive disease; Cardiovascular events; |
語文 | 英文(English) |
中文摘要 | 背景 以傳統都卜勒的方法所測得的踝臂血壓比已報告過可做為冠狀動脈病人心血管不良事件的指標。最近,有一個儀器,可用自動化脈衝式的方法來測量踝臂血壓比。但是用此種儀器測量的踝臂血壓比是否也可當做冠狀動脈病人心血管不良事件的指標,仍不清楚。方法和結果 我們從門診收了82位已做過心導管檢查的病人。我們以ABI-form (Colin VP1000) 的儀器為每一位病人測量踝臂血壓比,並以兩側較低一側的值當作分析的數值。我們將病人分為兩組,一組為踝臂血壓比大於或等於0.9、另一組為踝臂血壓比小於0.9,並比較這兩組病人的基本資料。我們追蹤這些病人20.0±3.6個月。我們分析踝臂血壓比和心血管不良事件的關係。然後我們用單變項分析去決定心血管不良事件的主要預測因子。最後再用多變項分析去找出心血管不良事件的決定因子。82位病人有14位病人的踝臂血壓比小於0.9,有68位病人的踝臂血壓比大於或等於0.9。踝臂血壓比小於0.9的病人,其年紀較大、尿酸較高;三條血管病變、糖尿病、高血壓和利尿劑使用的盛行率較高且因心血管病變而死亡和心血管不良事件的危險性也較高。在單變項分析時,踝臂血壓比小於0.9、三條血管病變和糖尿病是心血管不良事件的預測因子。在多變項分析後,踝臂血壓比小於0.9和三條血管病變仍是心血管不良事件的主要決定因子。結論 以此自動化脈衝式的方法所測得的踝臂血壓比,就像三條血管病變,可當做冠狀動脈病人心血管不良事件的指標。 |
英文摘要 | Background: Ankle-brachial index (ABI) measured by conventional Doppler method has been reported to be an independent predictor of adverse cardiovascular events in patients with coronary artery disease (CAD). Recently, a clinical device has been developed to measure ABI by an oscillometric method. It is unclear whether ABI measured by this device can serve as a significant predictor of cardiovascular events in patients with CAD. Materials and Methods: We included 82 patients from our outpatient clinic, who had received coronary angiography examination. ABI was determined in all subjects using the ABI-form (Cohn VP1000) device. The lower value of ABI in either of the right or left limbs was used for data analysis. We divided our subjects into two groups with either ABI<0.9 or ABI≥0.9 and compared basal characteristics between groups. We followed up these patients for 20.0±3.6 months (range 10 to 26). We analyzed the relationship between ABI and cardiovascular events. Then, we used univariate analysis to determine the significant predictors of cardiovascular events. Finally, we utilized multiple logistic regression analysis to identify the independent predictors of cardiovascular events. Results: There were 14 patients with ABI < 0.9 and 68 patients with ABI≥0.9. The patients with ABI < 0.9 were older and had higher plasma level of uric acid. The prevalence of three-vessel CAD, diabetes mellitus, hypertension, diuretic use, and the risk of cardiovascular death and cardiovascular events were significantly higher in the group of patients with ABI < 0.9. In a univariate analysis, cardiovascular events were significantly related to ABI < 0.9 (odds ratio: 12.6), three-vessel CAD (odds ratio: 12.5) and DM (odds ratio: 4.7). After a multiple logistic regression analysis, ABI < 0.9 and three-vessel CAD were still significant predictors of cardiovascular events. Conclusions: ABI measured by the automated oscillometric method, like three-vessel CAD, can serve as a useful parameter to predict cardiovascular events in patients with CAD. |
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