Amudha K, Chee K H, Tan K S, Tan C T, Lang C C
Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.
Int J Clin Pract. 2003 Jun;57(5):369-72.
Atherosclerosis is a progressive, disseminated condition that affects all the vascular beds. Peripheral arterial disease (PAD), a manifestation of atherosclerosis, measured non-invasively in the legs by ankle-brachial index (ABI) is associated with increased cardiovascular morbidity and mortality. Though several studies in the western industrialised countries have shown that PAD is widely prevalent in the general older population at risk, not much data are available in the South East Asian developing countries. We have conducted an epidemiological survey on the prevalence of PAD in high-risk patients at an urban hospital in Malaysia. A total of 301 consecutive patients aged 32-90 years were recruited during their follow-up clinic visits for established cardiovascular disease, ischaemic stroke or diabetes mellitus > or = 5 years. All participants underwent ABI measurement and were subjected to the Edinburgh claudication questionnaire to assess leg symptoms. The prevalence of PAD in our high-risk population was 23%, of which only 27% were symptomatic with the classical intermittent claudication. All the patients with PAD were diagnosed at the time of the study. PAD was found in 33% of patients with pre-existent cardiovascular disease, 28% in patients with ischaemic stroke and 24% in diabetic patients. PAD was also highly prevalent among the younger patients. Our study has shown that PAD is highly prevalent among high-risk Malaysian patients and is not necessarily a disease of older age. Only 27% of these patients were symptomatic. All the subjects with PAD were diagnosed at the time of the study, which would suggest it is an unrecognised and underdiagnosed condition, even in patients with atherosclerotic risk factors.
动脉粥样硬化是一种渐进性、弥漫性疾病，影响所有血管床。外周动脉疾病（PAD）是动脉粥样硬化的一种表现，通过踝臂指数（ABI）在腿部进行无创测量，与心血管发病率和死亡率增加相关。尽管西方工业化国家的多项研究表明，PAD在有风险的老年普通人群中广泛存在，但东南亚发展中国家的相关数据却不多。我们在马来西亚一家城市医院对高危患者中PAD的患病率进行了一项流行病学调查。在连续随访门诊中，共招募了301名年龄在32 - 90岁之间、患有已确诊心血管疾病、缺血性中风或糖尿病≥5年的患者。所有参与者均接受了ABI测量，并填写了爱丁堡跛行问卷以评估腿部症状。我们高危人群中PAD的患病率为23%，其中只有27%有典型间歇性跛行的症状。所有PAD患者均在研究时被诊断出来。在已有心血管疾病的患者中，33%发现有PAD；缺血性中风患者中为28%；糖尿病患者中为24%。PAD在年轻患者中也非常普遍。我们的研究表明，PAD在高危马来西亚患者中非常普遍，不一定是老年疾病。这些患者中只有27%有症状。所有PAD受试者均在研究时被诊断出来，这表明即使在有动脉粥样硬化危险因素的患者中，它也是一种未被认识和诊断不足的疾病。
