Detection of Peripheral Artery Disease by Duplex Ultrasonography among Hemodialysis Patients
Detection of Peripheral Artery Disease by Duplex Ultrasonography among Hemodialysis Patients
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DOI：
10.2215/cjn.09451209
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发表时间：
2010-12-01
影响因子：
9.8
通讯作者：
Akizawa, Tadao
中科院分区：
文献类型：
--
作者：
Ogata, Hiroaki;Kumata-Maeta, Chiaki;Akizawa, Tadao
背景和目的：外周动脉疾病（PAD）是血液透析患者心血管发病率和死亡率的已知预测因素。虽然踝臂血压指数 (ABI) 是一种简单而可靠的 PAD 筛查测试，但其敏感性在透析患者中会降低。 设计、设置、参与者和测量：我们进行了一项横断面门诊队列研究，使用下肢动脉双重超声检查来检查血液透析患者中 PAD 的患病率。我们还评估了动脉僵硬度增加对 PAD 筛查 ABI 准确性受损的影响。结果：在 315 名患者中，23.8% 患有 PAD。 PAD 与年龄较小、糖尿病、当前吸烟、动脉粥样硬化合并症、总胆固醇水平升高、甘油三酯水平升高和 Kt/V 降低有关。受试者工作特征分析（受试者工作特征曲线下面积=0.846）显示，ABI 值对 PAD 的敏感性和特异性分别为 49.0% 和 94.8%。 ABI 截止值 1.05 产生最佳敏感性 (74.5%) 和特异性 (84.4%)。 ABI水平的敏感性存在显着差异
Background and objectives: Peripheral arterial disease (PAD) is a known predictor of cardiovascular morbidity and mortality among hemodialysis patients. Although ankle-brachial BP index (ABI) is a simple and reliable test for PAD screening, its sensitivity has been suggested to decrease among dialysis patients.Design, setting, participants, & measurements: We performed a cross-sectional outpatient cohort study to examine prevalence of PAD among hemodialysis patients using duplex ultrasonography of the lower extremity artery. We also evaluate the influence of increased arterial stiffness on impaired accuracy of ABI for PAD screening.Results: Of 315 total patients, 23.8% had PAD. PAD was associated with younger age, diabetes, current smoking, atherosclerotic comorbidities, increased total cholesterol levels, increased triglyceride levels, and lower Kt/V. The receiver operating characteristic analysis (area under the receiver operating characteristic curve = 0.846) showed that sensitivity and specificity of ABI values for PAD were 49.0 and 94.8%, respectively. An ABI cut-off value of 1.05 resulted in the best sensitivity (74.5%) and specificity (84.4%). There was a significant difference in sensitivity of ABI levels