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首页> 外文期刊>Journal of Clinical Medicine Research >Resting and Post-Exercise Ankle-Brachial Index Measurements to Diagnose Asymptomatic Peripheral Arterial Disease in Middle Aged and Elderly Chronic Obstructive Pulmonary Disease Patients: A Pilot Study
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Resting and Post-Exercise Ankle-Brachial Index Measurements to Diagnose Asymptomatic Peripheral Arterial Disease in Middle Aged and Elderly Chronic Obstructive Pulmonary Disease Patients: A Pilot Study

机译：静息和运动后踝肱指数测量以诊断中老年人和老年慢性阻塞性肺疾病患者的无症状性外周动脉疾病：一项先导研究

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Background: Chronic obstructive pulmonary disease (COPD) patients are at risk for asymptomatic peripheral arterial disease (PAD) because smoking is a risk factor for COPD and PAD. The objectives of this study were to determine the proportion of COPD patients with asymptomatic PAD and to investigate whether the estimated risk of asymptomatic PAD in subjects with COPD differs using resting and exercise ankle-brachial index (ABI) in smokers.Methods: Using a cross-sectional study design, consecutive smokers > 50 years old were recruited over 2 months from the inpatient units and the outpatient clinics. Subjects previously diagnosed with PAD, unstable angina, recent (< 3 months) myocardial infarction or abdominal, intracranial, eye or lung surgery, and palliative care patients were excluded. Vascular risk factors, ABI (supine and post-3-minute walk supine), self-reported PAD symptoms, and spirometry were obtained. Two measurements of systolic blood pressure on all limbs were obtained using a sphygmomanometer and a Doppler ultrasound, and the ABI was calculated. Data were expressed as means ± standard deviation (SD). Dichotomous outcomes were assessed using Chi-square statistics; P-values of < 0.05 were considered significant.Results: Thirty patients with no previous diagnosis of PAD were recruited. Mean age was 67.7 years (SD: 10.5). Overall, 21 subjects (70%) had spirometry-proven COPD. Significant ABI for PAD (< 0.9) was seen in 7/21 COPD (33.5%) and 0/9 non-COPD subjects in the supine resting position (P = 0.07), and in 9/21 COPD (42.9%) vs. 0/9 non-COPD subjects after exercise (P = 0.03).Conclusions: A significant proportion of patients with spirometry-proven COPD screened positive for asymptomatic PAD after exercise. Resting ABI may not be very sensitive to diagnose asymptomatic PAD in COPD subjects. ABI may be a reliable, sensitive and practical screening tool to assess cardiovascular risk in COPD patients. Future large-scale studies are required to confirm this finding.J Clin Med Res. 2016;8(4):312-316doi: http://dx.doi.org/10.14740/jocmr2493w
机译：背景：慢性阻塞性肺疾病（COPD）患者有无症状性外周动脉疾病（PAD）的风险，因为吸烟是COPD和PAD的危险因素。这项研究的目的是确定吸烟者的静息和运动性踝臂指数（ABI），确定无症状PAD的COPD患者中无症状PAD的比例以及调查COPD患者无症状PAD的估计风险是否存在差异。截面研究设计，在住院单元和门诊部两个月内招募了连续吸烟> 50岁的吸烟者。排除先前诊断为PAD，不稳定型心绞痛，最近（<3个月）心肌梗塞或腹部，颅内，眼或肺部手术的患者，以及姑息治疗患者。获得了血管危险因素，ABI（仰卧和仰卧步行3分钟后），自我报告的PAD症状和肺活量测定。使用血压计和多普勒超声两次测量所有肢体的收缩压，并计算ABI。数据表示为平均值±标准差（SD）。使用卡方统计评估二分结果; P值<0.05被认为具有显着性。结果：招募了30例先前没有诊断为PAD的患者。平均年龄为67.7岁（标准差：10.5）。总体而言，有21名受试者（70％）患有肺活量测定证明的COPD。 PAD的ABI显着（<0.9）在仰卧卧位（P = 0.07）的7/21 COPD（33.5％）和0/9非COPD受试者中观察到，而9/21 COPD（42.9％）vs。运动后0/9名非COPD患者（P = 0.03）。结论：经肺活量测定证实的COPD患者中，有很大一部分运动后无症状PAD阳性。静息的ABI对诊断COPD患者的无症状PAD可能不是很敏感。 ABI可能是评估COPD患者心血管风险的可靠，敏感和实用的筛查工具。需要进一步的大规模研究来证实这一发现。JClin Med Res。 2016; 8（4）：312-316doi：http://dx.doi.org/10.14740/jocmr2493w

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