Aggarwal Saurabh, Loomba Rohit Seth, Arora Rohit
Ther Adv Cardiovasc Dis. 2012 Apr;6(2):53-70. doi: 10.1177/1753944712437359. Epub 2012 Feb 15.
The prevalence of peripheral artery disease is steadily increasing and is associated with significant morbidity, including a significant percentage of amputations. Peripheral artery disease often goes undiagnosed, making its prevention increasingly important. Patients with peripheral arterial disease are at increased risk of adverse cardiovascular outcomes which makes prevention even more important. Several risk factors have been identified in the pathophysiology of peripheral artery disease which should be modified to decrease risk. Smoking, hyperlipidemia, hypertension, and diabetes are among proven risk factors for the development of peripheral artery disease, thus smoking cessation, lipid control, blood pressure control, and glucose control have been tried and shown to be effective in preventing the morbidity associated with this disease. Pharmacologic agents such as aspirin and clopidogrel alone or in combination have been shown to be effective, though risk of bleeding might be increased with the combination. Anticoagulation use is recommended only for acute embolic cases. Other treatment modalities that have been tried or are under investigation are estrogen replacement, naftidrofuryl, pentoxifylline, hyperbaric oxygen, therapeutic angiogenesis, and advanced glycation inhibitors. The treatment for concomitant vascular diseases does not change in the presence of peripheral artery disease, but aggressive management of risk factors should be undertaken in such cases.
外周动脉疾病的患病率正在稳步上升，且与严重的发病率相关，包括相当比例的截肢病例。外周动脉疾病常常未被诊断出来，因此其预防变得越发重要。外周动脉疾病患者发生不良心血管事件的风险增加，这使得预防更为重要。在外周动脉疾病的病理生理学中已确定了若干风险因素，应对这些因素加以改变以降低风险。吸烟、高脂血症、高血压和糖尿病是外周动脉疾病发生的已证实的风险因素，因此，戒烟、控制血脂、控制血压和控制血糖已被尝试并证明在预防与此疾病相关的发病率方面是有效的。单独使用或联合使用阿司匹林和氯吡格雷等药物已被证明是有效的，不过联合使用可能会增加出血风险。仅在急性栓塞病例中推荐使用抗凝治疗。其他已被尝试或正在研究的治疗方式包括雌激素替代疗法、萘呋胺酯、己酮可可碱、高压氧、治疗性血管生成和晚期糖基化抑制剂。在外周动脉疾病存在的情况下，对合并的血管疾病的治疗并无改变，但在这种情况下应积极管理风险因素。
