Marso Steven P, Hiatt William R
Mid America Heart Institute, University of Missouri-Kansas City, Saint Luke's Hospital, Kansas City, Missouri 64111, USA.
J Am Coll Cardiol. 2006 Mar 7;47(5):921-9. doi: 10.1016/j.jacc.2005.09.065. Epub 2006 Feb 9.
Peripheral arterial disease (PAD) is a chronic, lifestyle-limiting disease and is an independent predictor of cardiovascular and cerebrovascular ischemic events. Despite the recognition that PAD is associated with a marked increase in the risk of ischemic events, this particular manifestation of systemic atherosclerosis is largely underdiagnosed and undertreated. The risk of PAD is markedly increased among individuals with diabetes, and ischemic event rates are higher in diabetic individuals with PAD than in comparable non-diabetic populations. Consequently, early diagnosis and treatment of PAD in patients with diabetes is critically important in order to reduce the risk of cardiovascular events, minimize the risk of long-term disability, and improve quality of life. A diagnosis of PAD in patients with diabetes mandates a multi-faceted treatment approach, involving aggressive risk-factor modification, antiplatelet therapy, and revascularization procedures. The American Diabetes Association recently issued a consensus statement on the epidemiology, pathophysiology, diagnosis, and management of PAD in patients with diabetes. This article will review the clinical implications of the consensus statement and highlight the treatment options available in order to help prevent future ischemic events in diabetic individuals with PAD.
外周动脉疾病（PAD）是一种慢性、限制生活方式的疾病，是心血管和脑血管缺血事件的独立预测因素。尽管人们认识到PAD与缺血事件风险的显著增加相关，但这种全身性动脉粥样硬化的特殊表现很大程度上未得到充分诊断和治疗。糖尿病患者发生PAD的风险显著增加，患有PAD的糖尿病患者的缺血事件发生率高于可比的非糖尿病人群。因此，对糖尿病患者进行PAD的早期诊断和治疗对于降低心血管事件风险、将长期残疾风险降至最低以及提高生活质量至关重要。糖尿病患者PAD的诊断需要多方面的治疗方法，包括积极的危险因素修正、抗血小板治疗和血运重建手术。美国糖尿病协会最近发布了一份关于糖尿病患者PAD的流行病学、病理生理学、诊断和管理的共识声明。本文将回顾该共识声明的临床意义，并强调可用的治疗选择，以帮助预防患有PAD的糖尿病个体未来发生缺血事件。
