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本研究目的在于确定踝部收缩期峰值速度(ankle peak systolic velocity,APSV)是否能够预测糖尿病足损伤的非治愈性。根据末稍动脉双向扫描,糖尿病患者如果发现有足部损伤,如溃疡、坏疽或组织坏死,而且没有可触知的足背脉搏,则被收入组。研究终点是被治愈或治愈中的足部损伤、血管再生、重大截肢术或死亡。研究包括100例诊断明确的糖尿病性肢体损伤。其中,43例糖尿病足损伤的肢体达到完全治愈或充分治愈的终点,而57例为非治愈的损伤。具有已治愈的或治愈中损伤的肢体APSV显著高于非治愈损伤的肢体:53.0cm/s(41.8～81.6)vs.19.2cm/s(12.4～26.5),P<0.0001。35cm/s是临界值点,在预测糖尿病足损伤的非治愈性上,APSV表现出敏感性92.9%(95%CI82%～97%)、特异性90.6%(95%CI76%～96%)、阳性预测值92.9%和阴性预测值90.6%。在血管再生之前和之后,APSV有显著差别:20.4cm/s(12.4～26.3)vs.48.8cm/s(36.1～80.8),P<0.0001。在本组病人中,APSV能够高度准确的预测糖尿病足损伤的非治愈性。
The purpose of this study was to determine whether ankle peak systolic velocity (APSV) can predict the non-healing of diabetic foot injury. According to the bidirectional arterial bi-directional scanning, patients with diabetes who were found to have foot injuries such as ulcers, gangrene, or tissue necrosis without a tactile dorsal pulse were included in the group. The study’s endpoint was foot injury, revascularization, major amputation or death during cure or cure. The study included 100 diagnosed diabetic limb injuries. Among them, 43 cases of diabetic foot injury limbs to achieve complete cure or full cure, and 57 cases of non-healing injury. The APSV of the limbs with cured or cured lesions was significantly higher than that of the non-healing damaged limbs: 53.0 cm / s (41.8 ~ 81.6) vs.19.2 cm / s (12.4 ~ 26.5), P <0.0001.35 cm / s was the critical APSV showed a sensitivity of 92.9% (95% CI 82% -97%), specificity of 90.6% (95% CI 76% -96%), and a positive predictive value of 92.9% in predicting the non-healing of diabetic foot injuries And negative predictive value of 90.6%. There was a significant difference in APSV between before and after revascularization: 20.4 cm / s (12.4 to 26.3) vs. 48.8 cm / s (36.1 to 80.8), P <0.0001. In this group of patients, APSV can predict the non-healing of diabetic foot injury highly accurately.