| Objective: To learn the relation ship between ankle-brachial index (ankle-brachial index, ABI) and the atherosclerosis multiple vascular beds damages in patients with non-cardiac ischemic stroke and its risk factors.Methods:Selected non-cardiac ischemic stroke patients for the study and evalued the ABI. According to the results, the subjects were divided into the normal ABI group and the lower ABI group. With carotid artery colour to exceed, the heart of color doppler ultrasound, electrocardiogram (ECG) or dynamic electrocardiogram and blood Cystatin (CysC), combined with the medical history of two groups of patients to evaluate the degree of atherosclerosis much damage to vascular beds.Results:Participants included122cases of ischemic cerebral apoplexy patients, of which89(72.95%) cases of normal ABI, ABI decrease in33(27.05%), only8(24.24%) patients had intermittent claudication symptoms.The values of ABI in lower ABI group were lower than normal group(0.74±0.15vs1.1±0.58, P<0.01). Comparing the proportionate two groups of patients with gender, smoking, drinking, there was no statistically significant difference (P>0.05); But two groups of ABI reduces high blood pressure in the group (78.79%vs51.69%), diabetes (45.45%vs21.34%), the prevalence of dyslipidemia (75.75%vs60.67%) were higher than normal group (P<0.05).The proportion of coronary heart disease (48.48%vs26.69%)and renal abnormalities (75.76%vs48.31%) in lower ABI group patients were higher than in normal group (P<0.05). And the median of CysC of lower ABI group was higher than normal group (1.46vs1.12,P<0.01). ABI values of two groups of patients with CysC linear correlation analysis showed no linear correlation relationship between them(P>0.05).To check out the situation of the carotid and vertebral artery or subclavian artery atherosclerosis of two groups,the rates of carotid artery atherosclerosis (100%vs82.02%) and carotid artery combined vertebral artery or subclavian artery atherosclerosis (66.67%vs41.57%) of lower ABI group were higher than normal group (P<0.05).Comparing the status of the two groups in patients with IMT thickening of carotid artery, the ratio of one and two thickening of IMT had no statistical difference(P>0.05);But the rate of three or more IMT thickening in lower ABI group patients was significantly higher than in normal group (81.81%vs53.93%,P<0.01).Comparing the status of the happening with coronary heart disease, kidney dysfunction, carotid or vertebral artery and subclavian artery atherosclerosis at the same time, the ratio of the two diseases had no obvious difference in two groups; With three diseases of lower ABI group was higher than the ratio of ABI normal group (27.27%vs8.99%,P<0.05). The decrease of ABI as the dependent variable, age, hypertension, diabetes, dyslipidemia, coronary heart disease, kidney dysfunction, carotid atherosclerosis as independent variables, make the multiariable Logistic regression analysis, the result showed age (OR=0.923,95%CI:0.857～0.994;P<0.05), diabetes (OR=0.183,95%CI:0.055～0.606;P<0.01), dyslipidemia (OR=0.243,95%CI:0.067～0.882;P<0.05),coronary heart disease (OR=0.327,95%CI:0.134～0.795;P<0.05)and abnormal renal function (OR=0.264,95%CI=0.101～.685, P<0.01) were independent risk factors for lower ABI in addition to high blood pressure and carotid atherosclerosis.Conclusion:A high incidence of abnormal ABI in patients of non-cardiac ischemic cerebral was apoplexy patients27.04%, of which only about24.24%of the patients with intermittent claudication symptoms. Age, diabetes, dyslipidemia, coronary heart disease and abnormal renal function was lower ABI independent risk factors. The ratio of coronary heart disease and renal abnormalities were higher in the lower ABI patients,and could prompt there were more damages to vascular beds of atherosclerosis in patients of non-cardiac ischemic stroke. Measured ABI was a simple, noninvasive method for screening of prediction of more atherosclerotic damages in vascular beds. |
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