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Studies on Peripheral Nerves and Vasculatures in Peripheral Artery Disease
Peripheral artery disease,neuropathy,ultrasound,duplex,Fontaine stage,
|Publication Year :||2019|
結果：我們招募了19名患者（平均年齡：69.9±8.9歲;男性: 11位）以進行進一步分析。在所有患者中，12名（63.2％）患者患有糖尿病，13名患者（68.4％）患有高脂血症。生活品質與Fontaine分期有相關。神經傳導檢查的異常率為85.7％。脛骨和腓神經的複合運動動作電位與Fontane分期，生活品質問卷和行走損傷問卷相關。 周邊動脈疾病組與正常組的橫截面積和神經高度指數相似。 周邊動脈疾病組和對照組之間手指動脈的阻力指數，近端足部的峰值收縮速度，遠端足的峰值收縮速度和遠端足的平均速度都有顯著差異。然而，只有遠端足的峰值收縮速度與Fontane分期，生活品質問卷和行走損傷問卷相關性良好。然而，超音波和神經傳導檢查之間沒有顯著的相關性。
Background: Peripheral artery disease (PAD) is a common disorder, affecting 3-10% in general population. It impaired the functional capacity and the quality of life. Intermittent claudication is the most famous symptoms of PAD, but there were only 10~20% patients with PAD presented this pathognomonic symptom. More patients present atypical symptoms or are asymptomatic. The discrepancy of the blood flow change and functional capacity also indicates the possibility of other mechanisms underlying the PAD. PAD-related neuropathy is one possible mechanism, but less investigated in the past. This study would explore the PAD-related neuropathy pathogenesis and the nerve damage change with the integrated examinations.
Methods: Patients, aged at least 20 years old, below the 90 years old, with diagnosis of PAD by the computed topography angiography or digital substraction angiography would be enrolled in this study. The data of clinical stage, questionaaires for quality of life (QOL) and walking ability, nerve conduction studies and nerve/vascular sonography would be collected. The analysis would be performed for (1)the comparison between the PAD and normal groups and (2) correlation between each parameters.
Results: Nineteen patients (mean age: 69.9 ± 8.9 years; male) were recruited for further analysis. Among all patients, 12 (63.2%) patients had diabetes mellitus, and 13 (68.4%) patients had hyperlipidemia. The questionnaires of quality of life were correlated to the Fontaine stage. The abnormality rate of nerve conduction study swas 85.7%. The compound motor action ptoential of tibial and peroneal nerve correlated to the Fontane stage, QOL, and walking impairment questionnaire. The cross sectional area and nerve height index were similar between the PAD group and normal group. The resistance index of the finger digital artery, peak systolic velocity of the proximal foot, peak systolic velocity of the distal foot, and mean velocity of the distal foot were siginifcantly different between the PAD and control groups. However, only the PSV of the distal foot correlated well to the Fontane stage, questionnaire of QOL, and walking impairment questionnaire. However, no significant correlation was noted between the ultrasound and nerve conduction studies.
Conclusion: This study showed the nerve conduction study and the flow velocity of the very distal artery of the foot could reflect the severity of PAD. However, the interaction between the very distal artery and nerve needs further study.
|Appears in Collections:||臨床醫學研究所|
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