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目的调查存在动脉粥样硬化危险因素人群中下肢动脉疾病(PAD)的发生率、共患率及治疗情况;评价踝臂指数(ABI)的临床应用价值及对心血管事件的预测价值。方法连续入选50岁以上伴多重危险因素的住院患者5 646例,测量ABI。进行PAD相关因素的多因素logistic回归分析。结果最终对5 263例患者进行分析。PAD总患病率为25.4%,女性患病率高于男性,PAD患者比非PAD患者年老,更多伴有糖尿病、冠心病、脑卒中、血脂紊乱和吸烟,PAD患者与非PAD患者的OR值证明这些因素与ABI相关。他汀类、血管紧张素转换酶抑制剂(ACEI)和抗血小板药物分别仅用于40.5%、53.6%、69.1%PAD患者。结论心血管高危患者中PAD患病率高,低ABI与全身性动脉粥样硬化具有相关性,ABI应成为心血管高危患者的常规检查,PAD患者需要得到强化治疗。
Objective To investigate the prevalence, comorbidity and treatment of lower extremity arterial disease (PAD) in people with atherosclerosis risk factors. To evaluate the clinical value of ankle brachial index (ABI) and its predictive value in cardiovascular events. Methods A total of 5 646 hospitalized patients over the age of 50 with multiple risk factors were enrolled in this study. ABI was measured. Multivariate logistic regression analysis of PAD-related factors was performed. Results Finally, 5,263 patients were analyzed. The overall prevalence of PAD was 25.4%. The prevalence of females was higher than that of males. PAD patients were older than non-PAD patients. Diabetes mellitus, coronary heart disease, stroke, dyslipidemia and smoking were more common in patients with PAD than in non-PAD patients OR values demonstrate that these factors are related to ABI. Statins, angiotensin-converting enzyme inhibitors (ACEIs) and antiplatelet drugs were used only in 40.5%, 53.6%, and 69.1% of PAD patients, respectively. Conclusions The prevalence of PAD in high-risk cardiovascular patients is high. Low ABI is associated with systemic atherosclerosis. ABI should be routinely tested in patients with high-risk cardiovascular disease. Patients with PAD need to be intensively treated.