[1]刘月 刘金波 刘欢 张琼阁 赵娜 赵红薇 王宏宇.血管危险因素、踝肱指数与下肢动脉粥样硬化闭塞症患者合并下肢静脉功能不全的相关性分析[J].心血管病学进展,2022,(6):554.[doi:10.16806/j.cnki.issn.1004-3934.2022.06.018]
　LIU Yue,LIU Jinbo,LIU Huan,et al.Association Analysis of Vascular Risk Factors,Ankle Brachial Index with Lower Extremity Atherosclerosis Disease Complicated by Chronic Venous Insufficiency[J].Advances in Cardiovascular Diseases,2022,(6):554.[doi:10.16806/j.cnki.issn.1004-3934.2022.06.018]
点击复制

血管危险因素、踝肱指数与下肢动脉粥样硬化闭塞症患者合并下肢静脉功能不全的相关性分析()
分享到：

《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2022年6期
页码:
554
栏目:
论著
出版日期:
2022-06-25

文章信息/Info

Title:
Association Analysis of Vascular Risk Factors,Ankle Brachial Index with Lower Extremity Atherosclerosis Disease Complicated by Chronic Venous Insufficiency
作者:
刘月1 刘金波1 刘欢1 张琼阁1 赵娜1 赵红薇1 王宏宇1; 2; 3; 4; 5
(1.北京大学首钢医院血管医学中心,北京 100144;2.北京市石景山区血管医学重点专科,北京 100144;3.北京大学医学部血管健康研究中心,北京 100144;4.北京大学分子心血管学教育部重点实验室,北京 100144;5.北京大学临床研究所心脏和血管健康研究中心,北京 100144)
Author(s):
LIU Yue1;  LIU Jinbo1;  LIU Huan1;  ZHANG Qiongge1;  ZHAO Na1;  ZHAO Hongwei1;  WANG Hongyu1; 2; 3; 4; 5
?1. Vascular Medicine Center,Peking University Shougang Hospital,Beijing 100144,China2. Beijing Shijingshan District Key Clinical Specialty of Vascular Medicine ,Beijing 100144 ,China3. Vascular Health Research Center of Peking University Health Science Center(VHRC-PKUHSC) ,Beijing 100144,China4. Key Laboratory of Molecular Cardiovascular Sciences ,Ministry of Education,Peking University,Beijing 100144,China5. Heart and Vascular Health Research Center of Peking University Clinical Research Institute(HVHRC-PUCRI) ,Beijing 100144,China)
关键词:
下肢动脉粥样硬化闭塞症; 下肢静脉功能不全; 血管危险因素; 踝肱指数
Keywords:
Lower extremity atherosclerosis disease;  Chronic venous insufficiency;  Vascular risk factors;  Ankle brachial index
DOI:
10.16806/j.cnki.issn.1004-3934.2022.06.018
摘要:
目的 分析血管危险因素与下肢动脉粥样硬化闭塞症合并下肢静脉功能不全（LEAD-CVI）患者的关系以及其踝肱指数（ABI）的特征。方法 选择2016—2019年于北京大学首钢医院血管医学科就诊的LEAD患者562例。CVI患者纳入合并组共94例，无CVI纳入单病组共468例。采用Pearson相关性分析、logistic回归分析分析血管危险因素和ABI与LEAD-CVI的关系。结果 合并组具有更低的糖尿病和高血脂的患病率、空腹血糖和糖化血红蛋白水平（Z=4.93，P=0.02；Z=4.46，P=0.04；Z=－1.97，P=0.04；Z=－2.42，P=0.02），更高的高同型半胱氨酸血症患病率和ABI（Z=5.75，P=0.02；Z=－3.79，P＜0.01）。糖尿病、糖化血红蛋白和高脂血症与LEAD-CVI具有负相关关系（r=－0.1，P=0.03；r=－0.11，P=0.01；r=－0.09，P=0.04）。高同型半胱氨酸血症与LEAD-CVI具有正相关关系（r=0.1，P=0.02）。糖尿病、空腹血糖、糖化血红蛋白、高脂血症和高同型半胱氨酸血症是LEAD-CVI的影响因素（β=－0.51，P=0.03；β=－0.12，P=0.04；β=－0.28，P=0.01；β=－0.54，P=0.04；β=0.58，P=0.02）。调整多影响因素的作用后，仅高同型半胱氨酸血症是LEAD-CVI的独立影响因素（调整后β=0.52，P=0.02）。结论 与 未合并CVI的LEAD患者相比，LEAD-CVI具有更高的ABI水平和高同型半胱氨酸血症患病率。高同型半胱氨酸血症是LEAD-CVI的独立影响因素。当LEAD-CVI时，需慎重考量把ABI作为LEAD严重程度分级的标准。
Abstract:
Objective To investigate the association of vascular risk factors with lower extremity atherosclerosis disease complicated by chronic venous insufficiency (LEAD-CVI) and the characteristic of ankle brachial index (ABI). Methods A total of 562 LEAD patients admitted in the Department of Vascular Medicine,Peking University Shougang Hospital from 2016 to 2019 were enrolled and assigned in comorbidity group with CVI (n=94) and single disease group without CVI (n=468). The relationship of vascular risk factors and ABI with LEAD-CVI was calculated by Pearson correlation and Logistic regression analysis. Results The comorbidity group showed a lower prevalence of diabetes mellitus (DM) and hyperlipidemia,fasting blood glucose (FBG) and HbA1c (Z=4.93,P=0.02;Z=4.46,P=0.04;Z=－1.97,P= 0.04;Z=－2.42,P=0.02),a higher prevalence of hyperhomocysteine and ABI (Z=5.75,P=0.02;Z=－3.79,P＜0.01). LEAD-CVI was negatively correlated with DM,HbA1c,hyperlipidemia (r=－0.1,P=0.03; r=－0.11,P=0.01; r=－0.09,P=0.04) but positively correlated with hyperhomocysteine (r=0.1,P=0.02). DM,FBG,HbAlc,hyperlipidemia and hyperhomocysteine were the influence factors for LEAD-CVI (β=－0.51,P=0.03;β = －0.12,P = 0.04; β = －0.28,P = 0.01; β = －0.54,P=0.04;β=0.58,P=0.02). After adjusted for confounding factors,only hyperhomocysteine was an independent risk factor for LEAD-CVI (adjusted β=0.52,P=0.02). Conclusion Compared to LEAD without CVI, LEAD-CVI showed a higher ABI level and a higher prevalence of hyperhomocysteine ,which was an independent influence factor for LEAD-CVI. Meanwhile,ABI should be carefully considered as the standard to classify LEAD severity for LEAD-CVI patients

参考文献/References:

[1].中华医学会外科学分会血管外科学组. 下肢动脉硬化闭塞症诊治指南[J] . 中华医学杂志,2015,95(24):1883-1896.
[2].Benjamin EJ,Muntner P,Alonso A,et al. Heart disease and stroke statistics—2019 update:a report from the American Heart Association[J]. Circulation,2019,139(10):e56-e528.
[3].Hedayati N,Carson JG,Chi YW,et al. Management of mixed arterial venous lower extremity ulceration:a review[J]. Vasc Med,2015,20(5):479-486.
[4].Zhao X,Bo L,Zhao H,et al. Cardio-ankle vascular index value in dyslipidemia patients affected by cardiovascular risk factors[J]. Clin Exp Hypertens,2018,40(4):312-317.
[5].M?kivaara LA,Ahti TM,Luukkaala T,et al. Persons with varicose veins have a high subsequent incidence of arterial disease:a population-based study in Tampere,Finland[J]. Angiology,2007,58(6):704-709.
[6].Yetkin E,Kilic S,Acikgoz N,et al. Increased prevalence of varicocele in patients with coronary artery ectasia[J]. Coron Artery Dis,2005,16(5):261-264.
[7].Chang SL,Huang YL,Lee MC,et al. Association of varicose veins with incident venous thromboembolism and peripheral artery disease[J]. JAMA,2018,319(8):807-817.
[8].Katsiki N,Perez-Martinez P,Mikhailidis DP. Homocysteine and non-cardiac vascular disease[J]. Curr Pharm Des,2017,23(22):3224-3232.
[9].Ammermann F,Meinel FG,Beller E,et al. Concomitant chronic venous insufficiency in patients with peripheral artery disease:insights from MR angiography[J]. Eur Radiol,2020,30(7):3908-3914.
[10].Matic M,Matic A,Djuran V,et al. Frequency of peripheral arterial disease in patients with chronic venous insufficiency[J]. Iran Red Crescent Med J,2016,18(1):e20781.
[11].Pearl L,Stephen E,Premkumar P,et al. Influence of body mass index on developing ulceration in patients with venous disease:a case control study[J]. Indian J Vascular En,2021,8(2):151-154.
[12].Onida S,Tan MKH,Kafeza M,et al. Metabolic phenotyping in venous disease:the need for standardization[J]. J Proteome Res,2019,18(11):3809-3820.
[13].Tanaka H,Zaima N,Sasaki T,et al. Loss of lymphatic vessels and regional lipid accumulation is associated with great saphenous vein incompetence[J]. J Vasc Surg,2012,55(5):1440-1448.
[14].Henriksen JR,Andresen TL,Feldborg LN,et al. Understanding detergent effects on lipid membranes:a model study of lysolipids[J]. Biophys J,2010,98(10):2199-2205.
[15].Koizumi S,Yamamoto S,Hayasaka T,et al. Imaging mass spectrometry revealed the production of lyso-phosphatidylcholine in the injured ischemic rat brai n[J]. Neuroscience,2010,168(1):219-225.
[16].Yang HJ,Ishizaki I,Sanada N,et al. Detection of characteristic distributions of phospholipid head groups and fatty acids on neurite surface by time-of-flight secondary ion mass spectrometry[J]. Med Mol Morphol,2010,43(3):158-164.
[17].Tanaka H,Zaima N,Yamamoto N,et al. Imaging mass spectrometry reveals unique lipid distribution in primary varicose veins[J]. Eur J Vasc Endovasc Surg,2010,40(5):657-663.
[18].Malanin K,Haapanen A,Kolari PJ,et al. The peripheral resistance in arteries of legs is inversely proportional to the severity of chronic venous insufficiency[J]. Acta Derm Venereol,1997,77(1):22-25.

更新日期/Last Update: 2022-08-05