老年下肢动脉闭塞患者的动脉造影特征及血清高敏C反应蛋白变化

Angiographic features and serum high sensitivity C-reactive protein level in elderly patients with peripheral arterial occlusive disease

摘要:

目的 分析老年下肢动脉闭塞患者动脉造影（DSA）的临床及病变特征，并测定血清高敏C反应蛋白（hs-CRP）水平，探讨hs-CRP检测的诊断意义。方法 回顾性地分析第三军医大学老年科2008年1月至2012年12月间收治的41例老年下肢动脉闭塞患者的临床资料。分析临床特点、血压水平、性别差异、DSA的病变特点、hs-CRP水平及其与DSA造影结果的相关性。结果 下肢动脉造影提示老年患者多存在多支、弥漫性病变，侧支循环形成差，症状较重，多以保守治疗为主。老年男性患者血压水平无明显升高，老年女性患者的收缩压水平高于男性患者，老年下肢动脉粥样硬化患者CRP明显增高，但无明显性别差异，也与病变的严重程度无关（P＜0.05）。结论 DSA检测显示老年下肢动脉闭塞的患者病变有其独特性，血压升高水平有性别差异，hs-CRP在多数患者中有升高，但是无性别差异，也不能完全评估严重程度。

Abstract:

Objective To analyze the features of lower extremity arterial occlusive disease in the elderly patients by digital subtraction angiography (DSA), and the serum level of high-sensitivity C-reactive protein (hs-CRP) in order to evaluate the diagnostic significance of hs-CRP testing. Methods Clinical data of 41 elderly patients with lower extremity arterial occlusive disease in our department from January 2008 to December 2012 were collected in this study. The clinical characteristics, blood pressure, gender differences, DSA features and serum level of hs-CRP were retrospectively analyzed. The correlation of serum level of hs-CRP was analyzed with angiographic results. Results DSA results indicated that the cohort of patients were characterized as multi-vessel?and diffuse lesions, poor collateral circulation and severe symptoms. So conservative treatments were mainly carried out for them. No obvious change was found in male blood pressure, but female patients had higher systolic pressure than male patients. The serum level of hs-CRP was obviously higher in the elderly patients with lower extremity arterial occlusive disease. But no significant difference was seen in the level between male and female patients. It also had no correlation with the severity (P＜0.05). Conclusion DSA shows that the lower extremity arteries in elderly patients with occlusive lesions have unique features. The blood pressure of the patients is increased and has gender difference. Serum level of hs-CRP is elevated in most patients, but has no gender difference and no correlation with the severity of lesions.