中华老年医学杂志
中華老年醫學雜誌
중화노년의학잡지
Chinese Journal of Geriatrics
2008年
9期
641-644
,共4页
李觉%乔永霞%孙英贤%郭晓铭%庞文跃%罗盈怡%胡大一
李覺%喬永霞%孫英賢%郭曉銘%龐文躍%囉盈怡%鬍大一
리각%교영하%손영현%곽효명%방문약%라영이%호대일
踝臂指数%下肢动脉疾病%受试者工作特征曲线
踝臂指數%下肢動脈疾病%受試者工作特徵麯線
과비지수%하지동맥질병%수시자공작특정곡선
Ankle brachial index%Lower extremity arterial disease%Receiver operator characteristics
目的 通过与数字减影血管造影(DSA)的对比,评价踝臂指数(ABI)诊断下肢动脉疾病的敏感性和特异性;研究ABI在人群筛检时的诊断界值. 方法 连续选取在上海同济大学和中国医科大学两所附属医院心内科住院患者383例,其中男性245例,女性138例,所有患者均接受DSA检查及ABI的测量.采用受试者工作特征曲线(ROC)分析曲线下面积和敏感性、特异性及似然比. 结果 在以DSA显示下肢动脉狭窄≥50%为诊断下肢动脉疾病的金标准时.ABI等于0.95诊断下肢动脉疾病的敏感性为93.0%,特异性为85.0%,阳性似然比为8.81,阴性似然比为0.23.ROC曲线F面积为0.953(95%CI为0.920～0.985). 结论 ABI可以代替DSA识别下肢动脉疾病的患者.在我国人群中,可以考虑用ABI等于0.95作为筛检下肢动脉疾病的诊断界点.
目的 通過與數字減影血管造影(DSA)的對比,評價踝臂指數(ABI)診斷下肢動脈疾病的敏感性和特異性;研究ABI在人群篩檢時的診斷界值. 方法 連續選取在上海同濟大學和中國醫科大學兩所附屬醫院心內科住院患者383例,其中男性245例,女性138例,所有患者均接受DSA檢查及ABI的測量.採用受試者工作特徵麯線(ROC)分析麯線下麵積和敏感性、特異性及似然比. 結果 在以DSA顯示下肢動脈狹窄≥50%為診斷下肢動脈疾病的金標準時.ABI等于0.95診斷下肢動脈疾病的敏感性為93.0%,特異性為85.0%,暘性似然比為8.81,陰性似然比為0.23.ROC麯線F麵積為0.953(95%CI為0.920～0.985). 結論 ABI可以代替DSA識彆下肢動脈疾病的患者.在我國人群中,可以攷慮用ABI等于0.95作為篩檢下肢動脈疾病的診斷界點.
목적 통과여수자감영혈관조영(DSA)적대비,평개과비지수(ABI)진단하지동맥질병적민감성화특이성;연구ABI재인군사검시적진단계치. 방법 련속선취재상해동제대학화중국의과대학량소부속의원심내과주원환자383례,기중남성245례,녀성138례,소유환자균접수DSA검사급ABI적측량.채용수시자공작특정곡선(ROC)분석곡선하면적화민감성、특이성급사연비. 결과 재이DSA현시하지동맥협착≥50%위진단하지동맥질병적금표준시.ABI등우0.95진단하지동맥질병적민감성위93.0%,특이성위85.0%,양성사연비위8.81,음성사연비위0.23.ROC곡선F면적위0.953(95%CI위0.920～0.985). 결론 ABI가이대체DSA식별하지동맥질병적환자.재아국인군중,가이고필용ABI등우0.95작위사검하지동맥질병적진단계점.
Objective To prospectively evaluate the sensitivity and specificity of ankle brachial index (ABI) in the diagnosis of lower extremity arterial disease(LEAD)by using conventional digital subtraction angiography (DSA) as the reference standard, and to research the threshold value of ABI screening test for diagnosis. Methods A total of 383 consecutive patients (245 men and 138 women, mean age (64.1±11.7) years] underwent conventional DSA and ABI measurement. Receiver operator characteristics (ROC) analysis was performed to assess possible threshold values for predicting the LEAD in these patients. Results Conventional DSA was used as the gold standard in defining≥50% luminal stenosis for the diagnosis of LEAD. 0. 95 was the overall cutoff of ABI which was associatcd with 93.0% sensitivity, 85.0% specificity, 8.81 positive likelihood ratio(+LR) and 0. 23 negative likelihood ratio(-LR) for detection of hemodynamically significant stenosis (lesions>≥50%) in all 383 subjects (P<0.01). The area under the ROC curve was 0. 953(95%CI 0.920～0.985). Conclusions ABI measurement is an accurate and reliable non-invasive alternative to conventional DSA in the diagnosis of lower extremity arterial disease. And the cut-off 0.95 is the threshold ABI value for detecting LEAD in Chinese population.
