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6880例初级保健患者外周动脉疾病及合并症的高患病率:横断面研究

High prevalence of peripheral arterial disease and co-morbidity in 6880 primary care patients: cross-sectional study.

作者信息

Diehm Curt, Schuster Alexander, Allenberg Jens R, Darius Harald, Haberl Roman, Lange Stefan, Pittrow David, von Stritzky Berndt, Tepohl Gerhart, Trampisch Hans-Joachim

机构信息

Department of Internal Medicine, Vascular Medicine, Affiliated Teaching Hospital, University of Heidelberg, Guttmannstr. 1, D-76307, Karlsbad, Germany.

出版信息

Atherosclerosis. 2004 Jan;172(1):95-105. doi: 10.1016/s0021-9150(03)00204-1.

Abstract

We aimed to obtain reliable data on the epidemiology, co-morbidities and risk factor profile of peripheral arterial disease (PAD) in general medical practise. In the cross-sectional part of the observational German Epidemiological Trial on Ankle Brachial Index (getABI study), 344 general practitioners throughout Germany determined the ABI of consecutive, unselected patients aged 65 years or older with bilateral Doppler ultrasound measurements. Additional assessments comprised patient history with the focus on atherothrombotic diseases, physical examination, and the WHO questionnaire on intermittent claudication. A total of 6880 patients were included (42.0% male, mean age 72.5 years, mean body mass index 27.3 kg/m(2), mean systolic/diastolic blood pressure 143.7/81.3 mmHg). The prevalence of PAD for men/women as indicated by an ankle brachial index (AB1)<0.9 was 19.8/16.8%. Patients with PAD were slightly older than patients without PAD, suffered more frequently from diabetes (36.6 vs. 22.6%; adjusted OR: 1.8), hypertension (78.8 vs. 61.6%; OR: 2.2), lipid disorders (57.2 vs. 50.7%; OR: 1.3) and other coexisting atherothrombotic diseases (any cerebrovascular event: 15.0 vs. 7.6%; OR: 1.8; any cardiovascular event: 28.9 vs. 17.0%; OR: 1.5). The data highlight the high prevalence of PAD in primary care. PAD patients are characterised by a high co-morbidity, particularly with regard to other manifestations of atherothrombosis. Doppler ultrasound measurement for ABI determinations is a non-invasive, inexpensive, reliable tool in primary care and enables GPs to identify patients at risk of PAD.

摘要

我们旨在获取普通医疗实践中关于外周动脉疾病(PAD)的流行病学、合并症及危险因素概况的可靠数据。在德国踝臂指数观察性流行病学试验(getABI研究)的横断面部分,德国各地的344名全科医生通过双侧多普勒超声测量,确定了连续入选的65岁及以上未经过挑选患者的踝臂指数。额外评估包括以动脉粥样硬化血栓形成疾病为重点的患者病史、体格检查以及世界卫生组织关于间歇性跛行的问卷。共纳入6880名患者(男性占42.0%,平均年龄72.5岁,平均体重指数27.3kg/m²,平均收缩压/舒张压143.7/81.3mmHg)。踝臂指数(AB1)<0.9表明男性/女性PAD患病率分别为19.8%/16.8%。患有PAD的患者比未患PAD的患者年龄稍大,更频繁地患有糖尿病(36.6%对22.6%;校正比值比:1.8)、高血压(78.8%对61.6%;比值比:2.2)、血脂异常(57.2%对50.7%;比值比:1.3)以及其他并存的动脉粥样硬化血栓形成疾病(任何脑血管事件:15.0%对7.6%;比值比:1.8;任何心血管事件:28.9%对17.0%;比值比:1.5)。这些数据凸显了基层医疗中PAD的高患病率。PAD患者的特点是合并症发生率高,尤其是在动脉粥样硬化血栓形成的其他表现方面。用于确定ABI的多普勒超声测量是基层医疗中一种无创、廉价且可靠的工具,使全科医生能够识别有PAD风险的患者。

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