《ABI(踝臂指数)检查》-精选·课件.ppt

足趾血压　Diabetics and Toe Pressures ABPI1.3时，需进行足趾血压测定和TBPI检查。　Undertake toe pressures and TBPI when ABPI1.3 (Brooks, 2001) 动脉血管中层钙化很少发生在趾端动脉　Calcification rarely extends to digital arteries (Vowden, 1999) 对于糖尿病患者应给予更加关注，需进行特殊的动脉检查，如足趾血压检查。“In patients with Diabetes Mellitus additional care should be taken and further arterial investigations undertaken such as toe pressures” (ETRS guideline 2003) 足趾血压　Diabetics and Toe Pressures 动脉PPG是检查足趾血压的最佳手段。Arterial PPG is the preferred technique to measure toe pressures (Vowden, 2002) 检测脚趾血压比多普勒操作简单得多　Easier than Doppler to measure toe pressures 消除通过声音探测脉搏恢复　Eliminates the need to audibly detect the return of the pulse 探头容易连接手指和脚趾　Sensors easily attach to fingers toes 血压测定时，充气袖带放气速度应为2－3mmHg/秒　Cuffs should be deflated at 2-3mmHg/sec (BHS, 2000) 足趾血压　Diabetics and Toe Pressures PPG检测足趾血压　Toe Pressures using PPG 135 140 上臂Brachial TBI計算法 TBPI calculations 足趾収縮期血圧　Toe systolic pressure 上臂収縮期血圧最大測定値Highest brachial systolic pressure 140 140 75 115 足趾　Toe = 75 = 0.54 = 115 = 0.82 右TBI Right TBPI 左TBI Left TBI 上臂Brachial 足趾血压　Diabetics and Toe Pressures 足趾血压　Diabetics and Toe Pressures TBI 0.65 病变 TBI 0.65-0.7 临界值 TBI 0.7 正常 总结 Summary 总结　Summary 针对高危人群需进行血管检查。　　Undertake vascular assessment for higher risk patients (NICE No. 10, 2004) ABI是诊断外周动脉病症PAD（甚至在未出现症状之前），评估其预后的简单、有效、无创的方法。 ABI测量可以用听诊器、光传感器或带血管探头的多普勒（Doppler）超声探测仪等多种仪器测量，但以Doppler法最为简便和准确，是测量ABI的金标准。 针对血管中层钙化的患者进行足趾血压及TBI测定。　　　　　　　　　　Measure toe pressures in patients with calcification (Vowden 1999) 北京迪美德尔科技有限公司 * ABI (踝臂指数) 检查 -------动脉粥样硬化无创性筛查 ABI Assessment 动脉粥样硬化的病理进程 Stable angina 稳定型心绞痛/intermittent claudication 间歇性跛行 Thrombosis 血栓 Atherosclerosis 动脉粥样硬化 unstable angina不稳定型心绞痛 MI 心梗 ischemic stroke/TIA 中风 critical limb ischemia 下肢缺血 CV death 心血管死亡 Pathologic progression to atherosclerosis 动脉粥样硬化的主要临床表现 Cerebrovascular disease 脑血管病 Coronary artery disease 冠状动脉疾病 Renal artery ste