Risk factors and incidence for peripheral arterial disease in patients with typical lumbar spinal stenosis.
Risk factors and incidence for peripheral arterial disease in patients with typical lumbar spinal stenosis.
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DOI：
10.14245/kjs.2014.11.3.183
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发表时间：
2014-09
期刊：
影响因子：
--
通讯作者：
Cho DC
中科院分区：
文献类型：
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作者：
Han MH;Lee DH;Park KS;Lee YS;Kim KT;Sung JK;Kim HK;Cho DC
间歇性跛行（IC）是外周动脉疾病（PAD）和腰椎管狭窄症（LSS）的典型症状。了解LSS患者PAD的发生率及危险因素，对预防血管疾病的误诊具有重要意义。因此，我们研究的目的是评估接受脊柱手术治疗的典型和严重LSS患者的PAD发生率和危险因素。回顾性研究了2012年6月至2013年6月在我院接受手术治疗的171例连续LSS和重度IC患者的PAD发生率。收集背景特征（性别、年龄）和PAD已知风险因素（如高血压、糖尿病、吸烟、高脂血症、卒中和缺血性心脏病）的数据。在入组的171例患者中，7例踝臂指数（ABI）异常。在这些患者中进行了计算机断层扫描血管造影（CTA），并对所有7例患者确定了PAD的最终诊断。所有LSS患者中PAD的发生率为4.1%（7/171）。与LSS组相比，LSSPAD组的卒中和缺血性心脏病明显更常见。多因素Logistic回归分析显示，年龄和卒中（p<0.05）是PAD的独立危险因素。为了防止致命性PAD的误诊，我们建议对有LSS和卒中史的患者进行ABI评估。
Intermittent claudication (IC) is a typical symptom of peripheral arterial disease (PAD) and lumbar spinal stenosis (LSS). In order to prevent misdiagnosis of vascular disease, it is important to know the incidence of and risk factors for PAD in patients with LSS. Therefore, the aim of our study was to evaluate the incidence of and risk factors for PAD in patients with typical and severe LSS who underwent spinal surgical treatment. The occurrence of PAD was examined retrospectively in 171 consecutive patients with LSS and severe IC who underwent surgical treatment at our hospital from June 2012 to June 2013. Data were collected on background characteristics (sex, age) and known risk factors for PAD, such as hypertension, diabetes mellitus, smoking, hyperlipidemia, stroke, and ischemic heart disease. Of the 171 patients enrolled, 7 had an abnormal ankle-brachial index (ABI). Computed tomography angiography (CTA) was performed in these patients, and a final diagnosis of PAD was established for all 7 patients. The incidence of PAD in all patients with LSS was 4.1%(7 of 171). Stroke and ischemic heart disease were significantly more common in the LSSPAD group compared with the LSS group. Multiple logistic regression analyses with a forced-entry method revealed that age and stroke (p<0.05) were independent risk factors for PAD. To prevent misdiagnosis of fatal PAD, we recommend ABI be assessed in patients with LSS and history of stroke.