therapeuticЮжно-Российский журнал терапевтической практикиSouth Russian Journal of Therapeutic Practice2712-8156РостГМУ10.21886/2712-8156-2021-2-2-56-61therapeutic-135Research ArticleОРИГИНАЛЬНЫЕ ИССЛЕДОВАНИЯORIGINAL RESEARCHСуммарная площадь каротидных атеросклеротических бляшек как маркер бессимптомного заболевания артерий нижних конечностейCarotid total plaque area as a marker of asymptomatic lower extremity arterial diseasehttps://orcid.org/0000-0001-5902-3803ГенкельВ. В.GenkelV. V.

Генкель Вадим Викторович, к.м.н., доцент кафедры Пропедевтики внутренних болезней

Челябинск

Vadim V. Genkel, Cand. Sci. (Med.), Associate Professor of Department of Propedeutics of Internal Medicine

Chelyabinsk

henkel-07@mail.ruhttps://orcid.org/0000-0002-7731-7730ШапошникИ. И.ShaposhnikI. I.

Шапошник Игорь Иосифович, д.м.н., проф., заведующий кафедрой Пропедевтики внутренних болезней

Челябинск

Igor I. Shaposhnik, Dr. Sci. (Med.), Professor, Head of Department of Propedeutics of Internal Medicine

Chelyabinsk

shaposhnik@yandex.ruhttps://orcid.org/0000-0002-7954-2990ЛебедевЕ. В.LebedevE. V.

Лебедев Евгений Владимирович, к.м.н., доцент кафедры Пропедевтики внутренних болезней

Челябинск

Evgeny V. Lebedev, Cand. Sci. (Med.), Associate Professor of Department of Propedeutics of Internal Medicine

Chelyabinsk

evgueni.lebedev@mail.ruhttps://orcid.org/0000-0003-3962-3662СалашенкоА. О.SalashenkoA. O.

Салашенко Алексей Олегович, к.м.н., доцент кафедры Пропедевтики внутренних болезней

Челябинск

Alexey O. Salashenko, Cand. Sci. (Med.), Associate Professor of Department of Propedeutics of Internal Medicine

Chelyabinsk

salachenko@hotmail.comФГБОУ ВО «Южно-Уральский государственный медицинский университет» Минздрава РоссииРоссияSouth-Ural State Medical UniversityRussian Federation202102062021225661Copyright © Генкель В.В., Шапошник И.И., Лебедев Е.В., Салашенко А.О., 20212021Генкель В.В., Шапошник И.И., Лебедев Е.В., Салашенко А.О.Genkel V.V., Shaposhnik I.I., Lebedev E.V., Salashenko A.O.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.therapeutic-j.ru/jour/article/view/135

Цель: изучить прогностическую значимость различных ультразвуковых маркеров атеросклероза сонных артерий в отношении наличия бессимптомного атеросклеротического заболевания артерий нижних конечностей (ЗАНК). Материалы и методы: в исследовании приняло участие 193 пациента с каротидным атеросклерозом. Всем пациентам было проведено дуплексное сканирование сонных артерий и артерий нижних конечностей. Суммарная высота атеросклеротических бляшек (cPS) определялась как общая высота всех бляшек в сонных артериях. Суммарная площадь атеросклеротических бляшек в сонных артериях (cTPA) оценивалась в продольном положении, площадь бляшек измерялась в режиме ручной трассировки. Результаты: бессимптомное ЗАНК было диагностировано у 31,6% пациентов. Увеличение cTPA в отличие от cPS и максимального стеноза сонных артерий являлось независимым предиктором ЗАНК и было связано с увеличением относительного риска его наличия в 6,78 раз (95% CI 2,48 – 18,5; p <0,0001). cTPA ≥42,5 мм2 позволяло диагностировать бессимптомное ЗАНК с чувствительностью 70,2% и специфичностью 73,0%. Заключение: у пациентов с каротидным атеросклерозом увеличение cTPA в отличие от cPS и степени стеноза сонных артерий являлось статистически значимым независимым предиктором ЗАНК.

Objective: to examine the prognostic value of ultrasound markers of carotid atherosclerosis in relation to the presence of asymptomatic lower extremity peripheral artery disease (PAD). Materials and Methods: the study included 193 patients with carotid atherosclerosis. All patients underwent duplex ultrasound scanning (DUS) of carotid and lower limb arteries. The carotid plaque score (cPS) was determined as the total height of all plaques in the carotid arteries. The carotid total plaque area (cTPA) was estimated in the longitudinal position, the area of plaque was measured in the manual trace mode.Results: asymptomatic lower extremity PAD was diagnosed in 31.6% of patients. The increase in cTPA, in contrast to cPS and the degree of carotid stenosis, was independent predictor of lower extremity PAD and was associated with an increase in the relative risk of its presence by 6.78 times (95% CI 2.48-18.5; p <0.0001). cTPA ≥42.5 mm2 made it possible to diagnose asymptomatic lower extremity PAD with a sensitivity of 70.2% and specificity of 73.0%. Conclusion: In patients with carotid atherosclerosis among carotid atherosclerosis markers only cTPA, in contrast to cPS and the degree of carotid stenosis, had an independent predictive value regarding the presence of asymptomatic lower extremity PAD.

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The authors declare that there are no conflicts of interest present.