Cheng S W, Ting A C, Lau H, Wong J
Department of Surgery, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong, China.
World J Surg. 1999 Feb;23(2):202-6. doi: 10.1007/pl00013161.
The epidemiology of atherosclerotic peripheral arterial disease (PAD) has rarely been studied in Asia. A prospective vascular registry consisting of 510 Chinese patients with PAD from a teaching hospital in Hong Kong disclosed a male/female ratio of 1.6:1.0 with a mean age of 72 years. The predominant pattern was femoropopliteal occlusive disease (49%). Half of all patients had tissue loss on presentation, more so in women (67%) than men (38%). Demographic and biochemical risk factors examined showed many similarities with the West, included smoking (59%), hypertension (55%), diabetes mellitus (42%), hypercholesterolemia (55%), elevated low density lipoprotein (LDL) (60%), triglycerides (31%), hyperfibrinogenemia (62%), and hyperglycemia (49%). Chinese female patients with PAD were older and had a high prevalence of diabetes mellitus (54%). Smoking is less a problem in women (28%). They suffered predominantly from femoropopliteal and distal vessel disease, and two-thirds presented with tissue loss. Female patients also have significantly higher levels of fasting glucose, cholesterol, triglyceride, LDL, and very low density lipoprotein (VLDL). Male patients were mostly smokers (80%) with a higher proportion of aortoiliac disease. Critical ischemia in the form of tissue loss was associated with female sex (p < 0.001), age (p < 0.001), nonsmoking (p < 0.001), diabetes (p < 0.005), a low hemoglobin/hematocrit (p < 0.001), a high white blood cell count (p < 0.001), and high levels of fibrinogen (p < 0.01) and cholesterol (p < 0.05). An increasing incidence of PAD was noted in Hong Kong. Most of the patients present late with advanced ischemia. It is possible that this disease pattern represents only a fraction of the true incidence of PAD in the territory.
亚洲地区对动脉粥样硬化性外周动脉疾病（PAD）的流行病学研究较少。一项前瞻性血管登记研究纳入了香港一家教学医院的510例中国PAD患者，结果显示男女比例为1.6:1.0，平均年龄为72岁。主要病变类型为股腘动脉闭塞性疾病（49%）。所有患者中有一半在就诊时存在组织缺失，女性患者（67%）比男性患者（38%）更为多见。所检查的人口统计学和生化危险因素与西方有许多相似之处，包括吸烟（59%）、高血压（55%）、糖尿病（42%）、高胆固醇血症（55%）、低密度脂蛋白（LDL）升高（60%）、甘油三酯（31%）、高纤维蛋白原血症（62%）和高血糖（49%）。中国女性PAD患者年龄较大，糖尿病患病率较高（54%）。吸烟在女性中问题相对较小（28%）。她们主要患有股腘动脉和远端血管疾病，三分之二的患者存在组织缺失。女性患者的空腹血糖、胆固醇、甘油三酯、LDL和极低密度脂蛋白（VLDL）水平也显著更高。男性患者大多吸烟（80%），主动脉髂动脉疾病的比例较高。以组织缺失形式出现的严重缺血与女性性别（p<0.001）、年龄（p<0.001）、不吸烟（p<0.001）、糖尿病（p<0.005）、低血红蛋白/血细胞比容（p<0.001）、高白细胞计数（p<0.001）以及高纤维蛋白原水平（p<0.01）和胆固醇水平（p<0.05）相关。香港地区PAD的发病率呈上升趋势。大多数患者就诊时已处于晚期严重缺血状态。这种疾病模式可能仅代表了该地区PAD真实发病率的一部分。
