Abstract: Background　At present，the prevalence of lower extremity arterial disease（LEAD）is gradually rising.In addition，many studies have proved that LEAD is associated with cardiovascular and cerebrovascular diseases and all-cause mortality.Previously，most patients were identified via abnormal ankle-brachial index （ABI of ≤0.90），by Doppler method.In recent years，oscillometric method has become a simple method for not only four-limb blood pressure measurement （OS-ABI）．but inter-arm difference （IAD） in blood pressure （BP） and inter-ankle BP difference （IAND）．Objective　To evaluate the screening value of OS-ABI and IAND detected by oscillometric method for LEAD.Methods　A total of 206 patients underwent vascular surgery were selected from October 2017 to April 2018 in the Second Affiliated Hospital of Nanchang University.Oscillographic method for blood pressure measurement was used to measure the blood pressure of limbs.OS-ABI and IAND were obtained.OS-ABI≤0.9 or IAND≥15 mm Hg were used as the diagnostic criteria for LEAD.Patients also needed to perform computed tomography angiography （CTA），with the results of CTA as the gold standard.Results　Among the 206 patients，182 cases （88.3%） were diagnosed as LEAD；169（82.0%）had ABI≤0.9 and 106 （51.5%） had IAND≥15 mm Hg.The sensitivity，specificity and accuracy of IAND≥15 mm Hg in the diagnosis of LEAD were 55.5%，79.2% and 58.3%，respectively.When OS-ABI ≤0.9 combined with IAND≥15 mm Hg，the sensitivity，specificity and accuracy of LEAD diagnosis were increased to 96.2%，70.8% and 93.2% respectively.Conclusion　OS-ABI is an effective index for LEAD screening.Combination of IAND and OS-ABI can improve the value of LEAD screening，which is worth popularizing in clinic.

Key words: Peripheral arterial disease, Computed tomography angiography, Ankle-brachial index, Oscillometric method

摘要： 背景　目前下肢动脉疾病（LEAD）的发病率正逐渐上升，LEAD与心脑血管疾病及全因死亡率之间的相关性也得到大量研究证明。以往，LEAD的确诊依赖于异常踝臂指数（ABI≤0.9），其主要通过多普勒法获得。示波血压测量法同步测量四肢血压不仅能获得示波踝臂指数（OS-ABI），还能同时获得臂间血压差异（IAD）及踝间血压差异（IAND）。目的　评价OS-ABI及IAND筛查LEAD的价值。方法　选取2017年10月—2018年4月在南昌大学第二附属医院就诊的206例血管外科患者。采用示波血压测量法同时测量患者四肢血压，得到OS-ABI和IAND，以OS-ABI≤0.9或IAND≥15 mm Hg（1 mm Hg=0.133 kPa）作为LEAD的诊断标准。同时患者完善CT血管造影检查（CTA），以CTA检查结果为金标准。结果　依据CTA结果，206例患者中，182例（88.3%）诊断为LEAD，169例（82.0%）OS-ABI≤0.9，106例（51.5%）IAND≥15 mm Hg。OS-ABI≤0.9诊断LEAD的灵敏度、特异度和准确性分别为91.8%、91.7%和91.7%。IAND≥15 mm Hg诊断LEAD的灵敏度、特异度和准确性分别为55.5%、79.2%和58.3%。当OS-ABI≤0.9和IAND≥15 mm Hg联合应用时，诊断LEAD的灵敏度、特异度和准确性分别提高至96.2%、70.8%和93.2%。结论　OS-ABI是筛查LEAD的有效指标，联合IAND可提高其筛查价值，值得在临床上推广应用。

关键词: 下肢动脉疾病, CT血管造影, 踝臂指数, 示波血压测量法