文档介绍：周围动脉疾病治疗指南解读ClassI Benefit>>>Risk Procedure/TreatmentSHOULDbeperformed/administeredClassIIa Benefit>>Risk AdditionalstudieswithfocusedobjectivesneededITISREASONABLEtoperformprocedure/administertreatmentClassIIb Benefit≥Risk Additionalstudieswithbroadobjectivesneeded;Additionalregistrydatawouldbehelpful Procedure/TreatmentMAYBECONSIDEREDClassIII Risk≥Benefit NoadditionalstudiesneededProcedure/TreatmentshouldNOTbeperformed/mendedisindicatedisuseful/effective/beneficialisreasonablecanbeuseful/effective/mendedorindicatedmay/mightbeconsideredmay/mightbereasonableusefulness/effectivenessisunknown/unclear/mendedisnotindicatedshouldnotisnotuseful/effective/beneficialmaybeharmful推荐级别及证据分级ClassI Benefit>>>Risk Procedure/TreatmentSHOULDbeperformed/administeredClassIIa Benefit>>Risk AdditionalstudieswithfocusedobjectivesneededITISREASONABLEtoperformprocedure/administertreatmentClassIIb Benefit≥Risk Additionalstudieswithbroadobjectivesneeded;Additionalregistrydatawouldbehelpful Procedure/TreatmentMAYBECONSIDEREDClassIII Risk≥Benefit NoadditionalstudiesneededProcedure/TreatmentshouldNOTbeperformed/administeredSINCEITISNOTHELPFULANDMAYBEHARMFULLevelB 单中心随机对照研究;或非随机性研究推荐级别及证据分级LevelA 经过多中心随机对照研究得到的一致性结论LevelC 无随机对照研究的专家共识或制定的治疗规范。危险因素PAD主要病因是动脉粥样硬化。导致动脉粥样硬化的危险因素包括(吸烟、糖尿病、血脂异常、高血压、高同型半胱氨酸血症、C反应蛋白升高)危险因素高危人群年龄大于70岁年龄大于50,小于70岁,有糖尿病或吸烟史年龄小于50岁,患糖尿病,同时合并(吸烟史;血脂异常;高血压;高同型半胱氨酸血症)任一危险因素既往有冠脉、脑血管或肾血管动脉硬化病史自然病程LimbMorbidityCardiovascularMorbidity/MortalityWorseningClaudication10-20%CriticalLimbIschemia1-2%NonfatalCVEvents20%Mortality15-30%StableClaudication70-80%CVCauses75%NonCVCauses25%筛査方法无创检测方法:Rose问卷调查、周围动脉搏动检查和ABI病史及体格检查对于检测PAD敏感性低、可重复性差使用Rose问卷调查严重低估了PAD的发生率。使用ABI较使用Rose问卷调查可使PAD的检出率增加2~7倍。ABI提示无症状PAD患者占4/5以上PAD发病率男女不同年龄组PAD发病率体格检查■颈动脉触诊听诊,是否有震颤或杂音■测量双侧上肢血压是否相同■腹部大血管听诊,是否有杂音.■触诊听诊肱动脉、挠动脉、尺动脉、股动脉、腘动脉及足背动脉和胫后动脉■足部检查:除去鞋袜,检查皮肤颜色、温度、溃疡、毛发分布、趾甲是否增生