Ankle-brachial Index is Associated with the Initial Severity of Acute Ischemic Stroke

踝肱指數與急性缺血性腦中風病患之初期嚴重度之關係

連啟勛(Chi-Hsun Lien) ； 溫晨帆(Chen-Fan Wen) ； 鄭啟清(Kee-Ching Jeng) ； 楊自強(Chi-Chiang Yang) ； 廖健仲(Chen-Chung Liao)

《童綜合醫學雜誌》 11卷1期 (2017/06) Pp. 20-25

摘要

The ankle-brachial index (ABI) is an easy and reliable tool for identifying patients with subclinical peripheral arterial disease. Abnormal ABI (＜0.9) is broadly used as an indicator of lower limb arterial disease and has been shown to predict all-cause mortality, vascular related deaths, and nonfatal cardiovascular events. Low ABI is an independent predictor of subsequent stroke, myocardial infarction, and death. However, data on the relationship between abnormal ABI and severity of acute ischemic stroke (AIS) is limited. The purpose of this study was to examine the relationship between ABI and severity of AIS. Consecutive patients with AIS were divided into three groups: low ABI (＜0.9), borderline ABI (0.9-1.0), and normal ABI (1.0-1.4). The results showed that among the 255 patients enrolled in this study, 18.8% had low ABI, 22.7% had borderline ABI, and 58.5% had normal ABI. Among patients with AIS, the initial National Institutes of Health Stroke Scale (NIHSS) scores were significantly different (p ＜ 0.001). Age and plasma levels of triglyceride were also significantly different (p = 0.034 and p = 0.018, respectively). There were no significant differences in gender, history of hypertension, diabetes, or cigarette smoking among the ABI groups. Patients with low ABIs were older, had higher plasma levels of triglyceride, and higher initial NIHSS scores. In conclusion, low ABI was associated with initial severity of AIS. Therefore, ABI may help to provide more effective care for these patients.

關鍵字

ankle-brachial index ； acute ischemic stroke

並列摘要

踝肱指數（ankle-brachial index, ABI）是一個簡單的可靠的工具用來鑑定在臨床上無症狀的週邊動脈疾病患者。一個不正常的踝肱指數（ABI＜0.9）是被廣泛用來作下肢週邊動脈疾病指標。研究顯示在急性缺血性腦中風患者或暫時性腦缺血患者中，低踝肱指數佔了很高的流行率。無論如何，目前少有資料提到有關於不正常的踝肱指數與急性缺血性腦中風的嚴重度之間的關連性。此研究的目的是去探討踝肱指數與急性缺血性腦中風的急性期的嚴重度關連性。急性缺血性腦中風患者依其踝肱指數分成：(1) 低踝肱指數（＜0.9) ，(2) 邊緣踝肱指數（0.9-1.0) 以及(3) 正常踝肱指數（1.0-1.4）三組進行分析比較。結果顯示在所有255 住院患者中，低踝肱指數佔18.8%，邊緣踝肱指數佔22.8% 以及正常踝肱指數佔58.4%。在三組踝肱指數群中，NIHSS（p= 0.018）有顯著的意義。另外，年齡（p＜0.001）及血清三酸甘油脂（p = 0.034）也有顯著的關連性。低踝肱指數病人有較高之年齡、三酸甘油脂與NIHSS ，而年齡、性別、高血壓、糖尿病及吸煙病史等則在三組病人間並無顯著差異。結論：不正常的踝肱指數與急性缺血性腦中風的嚴重度有明顯的關連性，所以踝肱指數可以幫助醫師給予這些患者更有效的預防與照護。

並列關鍵字

踝肱指數 ； 急性缺血性腦中風 ； 中風病患嚴重度