Studies on Peripheral Nerves and Vasculatures in Peripheral Artery Disease

• Main Authors: Hsueh-Wen hsueh, 薛學文
• Other Authors: 謝松蒼
• Format: Others
• Language: zh-TW
• Published: 2019
• Online Access: http://ndltd.ncl.edu.tw/handle/z3g853

碩士 === 國立臺灣大學 === 臨床醫學研究所 === 107 === 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.