Comparison between oscillometric- and Doppler-ABI in elderly individuals.
Comparison between oscillometric- and Doppler-ABI in elderly individuals.
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DOI：
10.2147/vhrm.s39785
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发表时间：
2013
影响因子：
2.9
通讯作者：
Fujiwara S
中科院分区：
文献类型：
--
作者：
Takahashi I;Furukawa K;Ohishi W;Takahashi T;Matsumoto M;Fujiwara S
外周动脉疾病（PAD）通常仍然认识不足，主要是由于检测踝臂指数（ABI）低值所需的专业技术技能。作为连续波多普勒超声标准方法的一种更简单、更快速的替代方法，我们对113例老年受试者（年龄范围：61至88岁）采用VP-2000进行了自动血压计ABI测量。两条腿的多普勒法测量的ABI标准差均大于多普勒法测量的ABI标准差（P < 0.001）。两种方法之间的ABI的相关性分别为0.46左腿和0.61右腿;这一结果似乎是由观察者之间的多普勒ABI测量值的变化。虽然在较低的ABI范围内，显示平均动脉血压计和多普勒ABI之间差异较大的趋势是显著的，但在平均ABI > 1.1的测量中几乎没有差异的迹象。两种方法之间的差异在吸烟者中明显大于非吸烟者（P = 0.09），但该差异不受其他潜在动脉粥样硬化风险因素的影响，包括检查时的年龄（P > 0.50）。在较低的ABI下，较大的差异导致多普勒方法比多普勒方法更好地检测PAD（灵敏度= 50%，特异性= 100%），尽管总体一致性不小（Cohen's Kappa = 0.65）。我们的研究结果表明，多普勒测量设备可以提供更准确的估计PAD的患病率在老年人比传统的多普勒方法。
Peripheral arterial disease (PAD) generally remains under-recognized, mainly due to the specialized technical skills required to detect the low values of the ankle-brachial index (ABI). As a simpler and faster alternative to the standard method using continuous-wave Doppler ultrasound, we evaluated automated oscillometric ABI measurement by VP-2000 with an elderly cohort of 113 subjects (age range, 61 to 88 years). The standard deviation in ABIs measured by the Doppler method was statistically greater than that measured by the oscillometric method for each of the two legs (P < 0.001). Correlations in ABIs between the two methods were 0.46 for the left leg and 0.61 for the right leg; this result appears to have been caused by interobserver variation in the Doppler ABI measurements. While the trend showing greater differences between average oscillometric- and Doppler-ABIs was significant at the lower ABI ranges, there was little indication of differences in measurements having an average ABI > 1.1. The difference between the methods was suggestively larger in subjects who were smokers than in non-smokers (P = 0.09), but the difference was not affected by other potential atherosclerotic risk factors, including age at examination (P > 0.50). A larger difference at lower ABIs led to better PAD detection by the Doppler method compared to the oscillometric method (sensitivity = 50%, specificity = 100%), although the overall agreement was not small (Cohen’s Kappa = 0.65). Our findings indicate that oscillometric devices can provide more accurate estimation of the prevalence of PAD in elderly individuals than the conventional Doppler method.