The Value Of Personal Vascular Laboratory On Evaluating The Structure And Function Of The Low Extremity Arteries

PartⅠThe Evaluation of Personal Vascular Laboratory on Diagnosing the Low Extremity Artherosclerosis DiseaseObjective to evaluate the value of personal vascular laboratory (PVL) in diagnosing the ischemic extremities site and degree of the patients with low extremity artherosclerosis disease.Methods 35 patients with low extremity artherosclerosis disease admitted by vascular department of our hospital are chosen to be inspected by PVL, CDUS and DSA before the operations. The results of PVL and CDUS are contrasted with DSA. We choose SPS10.0 as the statistical software.The statistical method of cross table is applied to evaluate the value of PVL in diagnosing LEASD by yielding the sensitivity, the specificity, the positive predictive value, the negative predictive value and the global accuracy. Results There is no statistical difference between PVL and DSA in diagnosing the lower extremity arteries disease(P=0.581), so does CDUS and DSA(P=1.000). campared with CDUS, PVL also has a satisfying concordance in diagnosing LEASD (P=0.549). I indicates that PVL has a satisfying concordance in diagnosing LEASD with CDUS and DSA. Take DSA as the reference, the sensitivity of PVL was 88.9%, the specificity was 96.6%, the positive predictive value was 84.4%, the negative predictive value was 93.6% and the global accuracy was 92.1%.In term of the pathological change degree, CDUS and DSA has a satisfying concordance, while PVL still has a certain difference with DSA.( P=0.1462)Conclusion As a noninvasive vascular test, PVL gives a high global accuracy and a satisfying concordance with CDUS. It can be commonly used as the first line test in the diagnosis and the determinat ion of the position and the degree of the disease. PartⅡChange of Hemodynamics in Lower limb artery of patients with hyperlipoidemiaObjective to determine the influence of hyperlipoidemia on hemodynamics of lower extremity arteries.Methods Outpatients and in-patients in our hospital with hyperlipoidemia and with similar situation without hyperlipoidemia during July 2005 to March 2007 was choosen as the subjects of research. they are separate to four groups: groupⅠis the control group, with 26 subjects ; groupⅡis hypertriglyceridemia group, with 30; groupⅢis hypercholesteremia group which is composed of 31 subjects; groupⅣis the combined hyperlipidemia group consisted of 24 subjects.Their blood fats ofempty stomach venous blood were examined. Moreover, Doppler techniques was applied to the patients of the four groups. The flow parameters including maximum velocity (Vm), resistance index (RI), pulsating index (PI) of lower extremity artery at femoral artery, superficial femoral artery, popliteal artery, posterior tibial artery and dorsalis pedis artery were all measured. The data were analyzed with SPSS10.0. Results were summarized as mean±standard deviation.χ2 test was used for differences in prevalence. One-way ANOVA was used to assess the differences in mean values between groups. P<0.05 was taken as statistically significant. Results The four groups have no siganificent difference on age, gender,smoking history and incidence rate of primary hypertension and diabetes(P>0.05); the BMI of groupⅠis much higher than the other three. The results of blood fats indicates that the level of TG in groupⅡandⅣis higher than groupⅠandⅢ, and the level of HDL-C in the former is lower than that in the latter. The level of TC in groupⅢandⅣis higher than that in groupⅠandⅡ.The level of LDL-C has no difference in the four groups. The results of camperation of lower extremity arteries segmental haemodynamics indicates that: the PI of femoral artery, superficial femoral artery in groupⅡandⅣ, superficial femoral artery in groupⅢand dorsalis pedis artery in groupⅣis higher than other groups; the RI of posterior tibial artery in groupⅡandⅣ,Vm of dorsalis pedis artery in groupⅣis higher than the other groups. The difference is magnificient in statistics(P<0.05).Conclusion The subtype of hyperlipoidemia has variable influences on hemodynamics of lower extremity arteries. Among these subtypes, hypertriglyceridemia and combined hyperlipidemia have more influence than the others. Furthermore, the influences on lower extremity arteries is heterogeneity. emoral artery, superficial femoral artery and dorsalis pedis artery can be influenced more easily. PI could be a sensitive reference in reflex the change of lower extremity arteries'hemodynamics.