| 贺超贵,李 可,陈克勤,彭汉武,邓文超.跨病灶压力梯度检测在下肢动脉硬化闭塞症腔内治疗的应用价值[J].,2021,(10):1955-1958 |
| 跨病灶压力梯度检测在下肢动脉硬化闭塞症腔内治疗的应用价值 |
| Application Value of Cross Lesion Pressure Gradient Testing in Endovascular Therapy for Lower Extremity Arterial Occlusive Disease |
| 投稿时间：2020-07-31 修订日期：2020-08-25 |
| DOI：10.13241/j.cnki.pmb.2021.10.033 |
| 中文关键词: 跨病灶压力梯度 下肢动脉硬化闭塞症 腔内治疗 相关性 |
| 英文关键词: Cross lesion pressure gradient testing Lower extremity arterial occlusive disease Endovascular therapy Correlation |
| 基金项目:湖南省教育厅科学研究项目（15C1211）；2019年长沙市科技计划项目（KQ1901001） |
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| 中文摘要: |
| 摘要 目的：探讨跨病灶压力梯度（TLPG）检测在下肢动脉硬化闭塞症腔内治疗中的应用价值。方法：选取2018年1月~2019年6月于长沙市第一医院住院并进行腔内治疗的73例下肢动脉硬化闭塞症患者，造影证实管腔病灶，并通过管腔真径测量记录其狭窄程度。予导丝通过病灶后，进行病灶前-后的管腔压力的测定并记录干预前压力梯度值。根据患者临床表现、术前病灶影像学检查及压力梯度值，决定是否进行球囊扩张和/或支架植入干预治疗。完成所有干预后再次进行病灶近-远端测压，并记录干预后压力梯度值，分析干预前TLPG与Fontaine分期、踝肱指数（ABI）、疼痛评分的相关性，分析TLPG与管腔狭窄程度的相关性，并分析干预前后压力梯度值差值与ABI指数差值、疼痛评分差值的相关性。结果：Spearman相关分析结果显示，干预前TLPG与Fontaine分期、ABI指数、疼痛评分呈正相关（P<0.05），TLPG与管腔狭窄程度未见明显相关性（P>0.05），干预前后压力梯度值差值与ABI指数差值呈正相关（P<0.05），与疼痛评分差值未见明显相关性（P>0.05）。结论：在腔内治疗过程中进行TLPG测定，可能成为指导下肢动脉硬化病变评估的客观精确指标，可能有助于临界性病变的干预指征把握，可能有助于客观评估干预的即时效果，从而为下肢动脉硬化闭塞症的规范腔内治疗，提供一定的指导和帮助。 |
| 英文摘要: |
| ABSTRACT Objective: To explore the application value of cross lesion pressure gradient testing in the endovascular therapy for lower extremity arterial occlusive disease. Methods: A total of 73 patients with lower extremity arterial occlusive disease who were hospitalized and underwent endovascular therapy in chang sha first hospital from January 2018 to June 2019 were selected. The lumen lesions were confirmed by angiography, and the stenosis degree was recorded by true diameter measurement of lumen. After the guidewire was passed through the lesion, the lumen pressure before and after the lesion was measured and the pressure gradient before intervention was recorded. Balloon dilation and/or stent implantation intervention were determined based on the patient's clinical presentation, preoperative imaging examination of the lesion, and pressure gradient. Again after completing all intervention for nearly - distal pressure lesions, and pressure gradient value after intervention were recorded. The correlation between TLPG and Fontaine stage, ankle brachial index (ABI ) and pain score were analyzed. The correlation between TLPG and the degree of lumen stenosis were analyzed. The correlation between the pressure gradient value difference, ABI index difference and pain score difference before and after intervention were analyzed. Results: Spearman correlation analysis showed that TLPG was positively correlated with Fontaine stage, ABI index and pain score before intervention(P<0.05). There was no significant correlation between TLPG and degree of lumen stenosis(P>0.05). There was a positive correlation between the pressure gradient value differenc and ABI index difference before and after intervention (P<0.05). There was no significant correlation with the pain score difference(P>0.05). Conclusion: TLPG measurement in the process of endovascular treatment may be an objective and accurate index to guide the evaluation of arteriosclerosis of lower extremity, may be helpful to grasp the indication of intervention of critical lesions, may be helpful to objectively evaluate the immediate effect of intervention, so as to provide some guidance and help for the standardized endovascular therapy for lower extremity arterial occlusive disease. |
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