Ann Intern Med. 2013 Sep 3;159(5):342-8. doi: 10.7326/0003-4819-159-5-201309030-00008.
Update of the 2005 U.S. Preventive Services Task Force (USPSTF) recommendation on screening for peripheral artery disease (PAD).
The USPSTF reviewed the evidence on the use of resting ankle-brachial index (ABI) as a screening test for PAD or as a risk predictor for cardiovascular disease (CVD). The review focused on resting ABI as the sole screening method; the diagnostic performance of ABI testing in primary care populations, unselected populations, and asymptomatic populations; the predictive value of ABI testing for major CVD outcomes in primary care or unselected populations; and the effect of treatment on general CVD and PAD-specific morbidity in patients with asymptomatic or minimally symptomatic PAD.
This recommendation applies to asymptomatic adults who do not have a known diagnosis of PAD, CVD, severe chronic kidney disease, or diabetes.
The USPSTF concludes that the current evidence is insufficient to assess the balance of benefits and harms of screening for PAD and CVD risk assessment with the ABI in adults. (I statement).
对 2005 年美国预防服务工作组(USPSTF)关于外周动脉疾病(PAD)筛查的建议进行更新。
USPSTF 审查了使用静息踝肱指数(ABI)作为 PAD 筛查试验或心血管疾病(CVD)风险预测指标的证据。审查重点是静息 ABI 作为唯一的筛查方法;ABI 检测在初级保健人群、非选择性人群和无症状人群中的诊断性能;ABI 检测对主要 CVD 结局在初级保健或非选择性人群中的预测价值;以及治疗对无症状或轻度症状性 PAD 患者的一般 CVD 和 PAD 特异性发病率的影响。
本建议适用于无症状成年人,他们没有已知的 PAD、CVD、严重慢性肾脏疾病或糖尿病的诊断。
USPSTF 得出结论,目前的证据不足以评估在成年人中使用 ABI 筛查 PAD 和 CVD 风险评估的利弊平衡。(I 声明)。