目的 研究踝臂指数(ABI)和无症状颅内动脉狭窄(ICAS)的相关性。方法 随机抽取5206名研究对象,进行问卷调查、体格检查、实验室检查及经颅多普勒超声(TCD)、ABI检测。颅内动脉狭窄依据经颅多普勒(TCD)诊断;ABI分类依据 2011 ACCF/AHA 指南: 异常ABI(ABI≤0.90), 临界ABI(0.91～0.99),正常ABI(1.00～1.40)。ABI与ICAS的相关性采用多因素 logistic 回归分析。结果 临界ABI(0.91～0.99)(OR=1.364,95%CI:1.024～1.818)和异常ABI(ABI≤0.90)(OR=1.890, 95%CI:1.345～2.658)均与无症状颅内动脉狭窄相关。进一步分组研究显示:在男性中, ABI≤0.90与ICAS密切相关(OR=2.143,95%CI:1.419～3.235) ,但在女性中,两者则无明显相关性。在60岁以上人群中,临界ABI(0.91～0.99)及ABI≤0.90均与ICAS的发生密切相关,OR值分别为1.963(95%CI:1.252～3.079)和2.771(95%CI:1.788～4.293),但在60岁以下人群中临界ABI及异常ABI均与ICAS无关。结论 在无症状人群中,ABI可以作为颅内动脉狭窄的风险评估指标,但其检测价值因不同性别及年龄而不同。
Abstract
Objective To study the relationships between the low ABI and asymptomatic intracranial artery stenosis (ICAS).Methods The current study involved 5206 participants. ICAS was assessed by Transcranial Doppler. ABI was defined and categorized according to the 2011 ACCF/AHA guideline: abnormal ABI(ABI≤0.90), borderline ABI( 0.91-0.99), normal ABI(1.00-1.40). Logistic regression analysis was used to study the association between a low ABI and the risk of ICAS.Results After adjustment for possible confounders, borderline ABI(OR=1.364, 95%CI:1.024-1.818) and abnormal ABI (OR=1.890,95%CI:1.345-2.658)were both found to be significantly related to asymptomatic ICAS in all the participants. Further subgroup analysis revealed that males with an abnormal ABI were more than twice (OR=2.143, 95%CI:1.419-3.235) as vulnerable to ICAS as those with a normal ABI,but not so in women. In participants aged 60 or above, borderline ABI and abnormal ABI were both associated with ICAS, and OR was 1.963(95%CI:1.252-3.079) and 2.771(95%CI:1.788-4.293) respectively.Conclusions ABI can be considered an index for assessment of risks of ICAS among asymptomatic people, but this association varies with age and gender.
关键词
无症状颅内动脉狭窄 /
ICAS /
踝臂指数 /
ABI /
危险因素
Key words
asymptomatic intracranial atherosclerosis /
ICAS /
ankle brachial index /
ABI /
risk factors
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