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Prevalence and Correlation Factors of Peripheral Arterial Disease in Hemodialysis Patients Defined By Ankle-Brachial Index (ABI)
以足踝－臂血壓比值方法檢視血液透析病患周邊動脈疾病的盛行率和相關因子
摘要
背景：血液透析病患有比較高的心臟血管疾病，其中包含周邊動脈疾病(peripheral arterial disease, PAD)。PAD是全身性粥狀動脈硬化的表徵。足踝一臂血壓比值(Ankle-brachial index, ABI)是一種非侵入性檢查，對PAD的診斷可靠性很高，本研究使用ABI來檢視血液透析病患周邊動脈疾病的盛行率和差異。 方法：一共收集68例血液透析病患，其中包含21例糖尿病病患，接受ABI檢查；ABI值等於或小於0.9，就可診斷為PAD。分析評估下列因素：糖尿病病例、年齡、透析年限(dialysis duration)、白蛋白濃度、Kt/V、鈣磷乘積(Ca×P production)、和iPTH。以檢視這些因素對PAD或ABI值是否有影響。 結果：PAD盛行率在糖尿病接受血液透析病患比一般血液透析病患還高。ABI值在一般血液透析病患，不因透析年限長短而有不同；但在排除了糖尿病病患，則ABI值在透析年限超過10年這組，比透析年限小於l年這組，呈現有意義的減少。年齡大小對ABI值沒有呈現有意義的影響。白蛋白濃度在PAD組比非PAD組呈現有意義的降低。Kt/V、Ca×P production和iPTH值，在PAD組比非PAD組呈現沒有意義的相差。 結論：本研究發現糖尿病和白蛋白濃度在PAD組和非PAD組呈現有意義的差別。ABI值在非糖尿病患者，在透析年限超過10年這組，比透析年限小於1年這組，呈現有意義的減少。
並列摘要
Background: Cardiovascular diseases including peripheral arterial disease (PAD) are high/v prevalent among hemodialysis patients. PAD is one of the important manifestations of systemic atherosclerosis and is related to poorer quality of life among patients with end-stage renal disease (ESRD). In this study, we evaluated the prevalence and correlation factors of PAD in hemodialysis patients using the ankle-brachial index (ABI). Method: We enrolled 68 patients including 21 DM patients with ESRD undergoing hemodialysis. PAD was defined by an ABI of ≤0.9. Correlation factors including DM, age, hemodialysis duration (vintage), albumin level, Kt/V, Ca×P production, and iPTH were analyzed. Results: We found that the DM group has higher rate of PAD than tile all-patients group (non-DM + DM) (PAD/total: 32% vs. DM with PAD/DM. 55%, p＜0.05). There was no significant difference in ABI value for the all-patients group with different dialysis durations. However, the difference in ABI value between non-DM patients on dialysis for less than 1 year and those on dialysis for more 10 years was significant (p＜0.05). There was no significant difference in ABI value between patients of different ages for both all-patients and non-DM patients groups. The PAD group had significantly lower albumin level than the non-PAD group (p＜0.05). There were no significant differences in Kt/V, Ca×P production and iPTH values between the PAD and non-PAD groups. Conclusion: In this study, PAD was more prevalent among DM patients on hemodialysis. The albumin level was significantly lower in the PAD group. The ABI value was significant/v lower in non-DM patients on dialysis for more than 10 years than in those on dialysis for less than 1 year.
延伸閱讀
- 周明瑾、李素珠、黃麗利、謝妙玲、陳瑞忻、陳秋月、麥秀琴（2010）。利用踝臂血壓比來預測血液透析病人的死亡率。高雄護理雜誌，27(2)，7-19。https://doi.org/10.6692/KJN-2010-27-2-2
- 陳妙佩、陳建文、蕭善良、毛鴻忠（2012）。踝臂指數檢測可能可以作為血液透析病人周邊動脈疾病的例行篩檢。腎臟與透析，24(3)，220-225。https://doi.org/10.6340/KD.2012(3).12
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