脚-手臂指数:实用性,徒劳性和诊断标准
Ana I Casanegra1, David A Liedl2, Charlene McCarter3
1Gonda Vascular Center, Department of Cardiology, Division of Vascular Medicine, Mayo Clinic, Rochester, MN, USA.
Angiology
|January 22, 2025
概括
脚腕指数 (TBI) 是足腕指数 (ABI) 的可靠替代品,用于诊断周围动脉疾病 (PAD),特别是在患有非压缩血管的患者中. 这项研究提出了用于PAD诊断的新的TBI标准.
科学领域:
- 血管医学 血管医学
- 诊断成像 诊断成像 诊断成像
- 生物医学工程 生物医学工程
背景情况:
- 脚臂指数 (ABI) 是对外周动脉疾病 (PAD) 的标准诊断工具.
- 在患有非压缩动脉的患者中,ABI可能不可靠,需要使用替代方法.
- 脚臂指数 (TBI) 在这些具有挑战性的情况下为评估PAD提供了一个潜在的解决方案.
研究的目的:
- 评估可行性,并建立一个大患者群体的手指甲指数 (TBI) 的报告标准.
- 为了确定外围动脉疾病 (PAD) 的TBI的诊断准确性.
- 为PAD诊断和严重程度评估提出标准化的TBI标准.
主要方法:
- 在26,719个肢体中分析多普勒波形和细分压力.
- 在无法获得ABI的四肢中计算TBI.
- 将TBI值与ABI和多普勒波形特征进行比较,以定义PAD子组.
主要成果:
- 在所有四肢的92.7%和82%的四肢中成功获得了TBI,无法获得ABI.
- 创伤损伤截止值为0.8,表明PAD的0.99负预测值.
- 0.6的TBI截止值显示PAD的0.95正预测值,其中99.5%的PAD病例TBI<0.8.
结论:
- 脑损伤是诊断PAD的可行和可靠指标,特别是在患有非压缩血管的患者中.
- 建议的TBI标准包括正常 (>0.8),边界 (0.8-0.61),异常 (≤0.6) 和严重的PAD (≤0.2).
- 创伤提供了有价值的诊断信息,可以有效地纳入临床实践,用于PAD评估.
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