Chong P F, Golledge J, Greenhalgh R M, Davies A H
Department of Vascular Surgery, Charing Cross Hospital, London, U.K.
Eur J Vasc Endovasc Surg. 2000 Jul;20(1):4-12. doi: 10.1053/ejvs.2000.1112.
To compare the outcome of exercise therapy or angioplasty for the treatment of patients with intermittent claudication.
A summation analysis.
A search using MEDLINE and PUBMED between 1966 and April 1999 followed by a review of the manuscripts yielded 54 studies involving angioplasty and 27 studies involving exercise therapy for intermittent claudication. Studies were only included (12 angioplasty and nine exercise series) when results were available for patients with intermittent claudication alone, and when outcome was assessed in terms of symptoms at a minimum of 6 months.
The total number of claudicants undergoing exercise therapy was 294 patients, with a mean symptomatic success rate of 38. 4% and a mean improvement in maximum walking distance of 189.7% at 6 months. The total number of claudicants undergoing angioplasty was 2071, with a mean overall symptomatic success rate of 76.6%. The mean overall complication rate was 9% and mean major complication rate was 2.7% for the angioplasty studies.
Although the result demonstrates an advantage of angioplasty over exercise therapy at 6 months, there is a small risk of major complications. However, comparison of studies was impaired due to disparity in patient numbers, limited follow-up time and lack of uniformity in outcome assessment. In order to achieve a valid comparison of these therapies in a future randomised study, a validated disease-specific instrument for the assessment of symptomatic outcome for claudicants is required.
比较运动疗法或血管成形术治疗间歇性跛行患者的效果。
汇总分析。
检索1966年至1999年4月期间的MEDLINE和PUBMED数据库，随后查阅相关手稿，共获得54项涉及血管成形术的研究和27项涉及间歇性跛行运动疗法的研究。仅纳入那些仅针对间歇性跛行患者得出结果，且至少在6个月时根据症状评估结局的研究（12项血管成形术研究和9项运动疗法系列研究）。
接受运动疗法的跛行患者总数为294例，6个月时症状改善成功率平均为38.4%，最大步行距离平均改善189.7%。接受血管成形术的跛行患者总数为2071例，总体症状改善成功率平均为76.6%。血管成形术研究的总体并发症平均发生率为9%，主要并发症平均发生率为2.7%。
虽然结果表明在6个月时血管成形术比运动疗法更具优势，但存在发生主要并发症的小风险。然而，由于患者数量差异、随访时间有限以及结局评估缺乏一致性，研究比较受到影响。为了在未来的随机研究中对这些疗法进行有效比较，需要一种经过验证的针对特定疾病的工具来评估跛行患者的症状结局。
