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[目的]观察踝臂指数(ABI)与趾臂指数(TBI)对高血压合并代谢综合征患者(MS)未来心血管事件发生预后的预测价值。[方法]2007年7月～2009年4月某院住院的高血压合并MS患者157例和未合并MS的高血压患者63例,入院后测定其ABI、TBI、糖化血红蛋白(HbAlc)、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白(LDL)、血尿酸(UA)水平。根据患者的ABI和TBI进行分组,分为正常组、ABI降低组、TBI降低组和严重病变组,对入选患者进行随访,观察患者入院后12个月内主要心血管不良事件的发生情况,分析ABI和TBI与主要心血管不良事件之间的相关关系。[结果]严重病变组、ABI降低组、TBI降低组与正常组相比,动脉粥样硬化危险因素HbAlc、TC、TG、LDL、UA水平均明显较高,各组间比较差异有统计学意义(P﹤0.05);和对照组相比,合并MS高血压患者心脑血管事件发生率明显增加(P﹤0.05);ABI与TBI对合并MS高血压患者评估心脑血管事件,均有统计学意义(P﹤0.05)。[结论]对高血压合并代谢综合征患者,ABI和TBI降低对冠状动脉严重病变和心脑血管事件有预测价值。
[Objective] To observe the predictive value of ankle brachial index (ABI) and toe index (TBI) on prognosis of future cardiovascular events in patients with metabolic syndrome (MS). [Methods] From July 2007 to April 2009, 157 patients with hypertension and MS without hypertension in hospital of a hospital were enrolled in this study. After admission, their ABI, TBI, HbAlc, total cholesterol TC, TG, LDL and UA were measured. According to the patients’ ABI and TBI, the patients were divided into normal group, ABI reduction group, TBI reduction group and severe disease group. The patients were followed up and the occurrence of major cardiovascular adverse events within 12 months after admission were observed. Correlation between ABI and TBI and major adverse cardiovascular events. [Results] The levels of HbAlc, TC, TG, LDL and UA in atherosclerotic risk factors of severe disease group, ABI reduction group and TBI reduction group were significantly higher than those of normal group, with significant difference between the groups (P <0.05). Compared with the control group, the incidence of cardiovascular and cerebrovascular events was significantly increased in patients with MS hypertension (P <0.05). ABI and TBI were used to evaluate the cardiovascular and cerebrovascular events in MS patients with hypertension, Significance (P <0.05). [Conclusion] The decrease of ABI and TBI in patients with hypertension complicated with metabolic syndrome has predictive value on the severe coronary artery disease and cardiovascular and cerebrovascular events.