Reny J L, Cabane J
Service de médecine interne, hôpital Saint-Antoine, Paris, France.
Rev Med Interne. 1998 Jan;19(1):34-43. doi: 10.1016/s0248-8663(97)83697-1.
To review clinical data, pathophysiology and treatment of thromboangiitis (Buerger's disease).
Buerger's disease or thromboangiitis obliterans (TAO) is an obliterative vascular disease that affects medium and small sized arteries as well as superficial veins. Young males and smokers are preferentially afflicted with the disease. TAO accounts for 0.5 to 5% of occlusive vascular disease. Though TAO has a world-wide distribution, it can be found with greater prevalence in Eastern Europe, the Mid-East, Asia, and Southeast Asia. Women account for 10 to 20% of the patients and 5 to 10% are more than 60-years-old. Approximately 95% are smokers and disease activity is strongly associated with the use of tobacco. The pathogenesis is poorly understood and most hypotheses are controversial. There is no specific marker of the disease and the diagnosis is based on clinical and angiographic criteria. The disease spontaneously leads to tissue loss and major amputations. This can generally be avoided by discontinuing smoking. Induced hypervolemia and prostacyclins are effective treatments of critical limb ischemia in TAO.
If pathophysiology is still poorly understood, spontaneous evolution can be avoided by stopping tobacco and prostacyclin.
回顾血栓闭塞性脉管炎（伯格氏病）的临床数据、病理生理学及治疗方法。
伯格氏病或血栓闭塞性脉管炎（TAO）是一种闭塞性血管疾病，累及中、小动脉以及浅表静脉。年轻男性及吸烟者更易患此病。TAO占闭塞性血管疾病的0.5%至5%。尽管TAO在全球范围内均有分布，但在东欧、中东、亚洲及东南亚地区更为常见。女性患者占10%至20%，5%至10%的患者年龄超过60岁。约95%的患者为吸烟者，疾病活动与吸烟密切相关。其发病机制尚不清楚，多数假说存在争议。该病无特异性标志物，诊断基于临床及血管造影标准。该病可自发导致组织缺失及大截肢。一般通过戒烟可避免这种情况。诱导性高血容量和前列环素是治疗TAO严重肢体缺血的有效方法。
如果对病理生理学仍了解不足，通过戒烟和使用前列环素可避免疾病的自然进展。
