目的 初步探讨踝臂血压指数(ABI)对于糖尿病伴发急性缺血性脑血管病的预测价值.方法按照临床表现1∶3配对设计的原则,连续收集本院2010年10月~2012年10月神经内科因脑梗死住院的患者(45~85岁),分为糖尿病伴有急性脑梗死患者组(实验组,DMP组)、糖尿病组(配对对照组,NDMP组),统计其一般临床资料和不同时间段的ABI值,采用相关回归分析探讨ABI与糖尿病患者并发急性缺血性脑血管病的关系.结果 (1)共选取到168名患者,其中DMP组42例(男23例,女19例),NDMP组126例(男72例,女54例),两组患者在一般的心脑血管病危险因素上无明显差异,具有可比性(P=0.482>0.05);(2)急性期 DMP组与NDMP组相比ABI值差异显著,DMP组患者的ABI值明显下降(P=0.019<0.05);(3)经治疗后复测患者的ABI值,发现ABI值明显增加(P=0.006<0.01); (4)相关分析显示,ABI<0.90时与糖尿病患者发生急性脑梗死的相关系数OR=2.08(95%CI 1.40~2.84,P=0.001<0.01).其与急性脑梗死的发生呈正相关.结论 ABI检测操作简单,可以作为简易识别糖尿病伴发急性脑梗死的预测指标.%Objective To investigate the predictive value of the ankle-brachial index (ABI) in the diabetes associated with acute ischemic cerebral vascular disease. Methods In accordance with the clinical manifestations of the 1:3 matching design principle, we continuously collected the hospitalized patients (45-85 years old) of cerebral infarction in neurology department of our hospital during October 2010-October 2012. Then the patients were divided into diabetes with acute cerebral infarction patients (experimental group, DMP group) and diabetic group (matched control group, NDMP group). The general clinical data and ABI value in different time periods were valued. The correlation and regression analysis of ABI and diabetes in patients with acute ischemic brain vascular relationship were done. Results (1) we totally selected 168 patients, of which the DMP group were 42 cases (male 23, female 19), NDMP group were 126 patients (72 male, 54 female). There were no significant difference of the general cardio-cerebral vascular and disease risk factors between the two groups (P=0. 482>0. 05). (2) The ABI values were decreased significantly in the acute phase of DMP group patients (P = 0. 019<0. 05). (3) After treatment, we retested the ABI value. The ABI value increased significantly compared with the acute phrase (P =0. 006<0. 01). (4) Correlation analysis showed that ABI < 0.90 correlation coefficient with diabetic patients with acute cerebral infarction (OR= 2.08, 95% CI 1.40-2. 84, P =0. 001<0. 01). A positive correlation with the occurrence of acute cerebral infarction and ABI were discovered. Conclusions ABI can be used as a routine and simply test to improve the identification of the diabetic patients with high risk factors of occulting acute stroke. ABI has important clinical reference value in the assessment of patients with diabetes associated with acute cerebral vascular disease.
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