心血管疾病诊断及筛查评估体系.pptVIP

脑卒中与ＡＢＩ筛查相关性 ABI≤０.９者发生缺血性脑卒中的可能性是ＡＢＩ大于０.９者的１.５５倍 ＡＢＩ小于０.９者所有脑卒中患者是ＡＢＩ≥0.9患者２倍。 结论：缺血性脑卒中患病危险随ＡＢＩ降低而增加。 高血压病ＡＢＩ筛查、评估体系 ＡＢＩ正常指数１.3-0.9之间 ＥＨ患者与ＡＢＩ 指数负相关 ＥＨ患者与ＡＢＩ 指数正相关 年龄 ＥＨ病程 低密度脂蛋白浓度 高密度脂蛋白浓度 血浆Apelin浓度 医患供利 检查全过程对病人无创 统一医保收费（约120元/次） ABI 诊断体系的临床应用 外 周 动 脉 病 下肢ＰＡＤ筛查 慢性肾功能不全 外周血管病的认知和现状 　 近年来国内多项大规模临床实验已经证实：ＡＢＩ异常是心脑血管事件和病死率强有利的预测因子。ＡＢＩ的临床价值在国外已经有很广泛的价值。 　　　 美国第五次心脏协会预防学术会议最近指出，５０岁以上的冠心病危险中等或者更高的个体应为ＡＢＩ测量的适应症。 ABI对下肢PDA的筛查 　　　 ABI的正常值为0.9-1.3。ABI≤0.9已经被确定为PAD的诊断标准，ABI≤0.9确诊下肢PAD的敏感和特异度均为95% 　　　ABI用于PAD的筛查价格低廉、无创、简单易行，实用ABI测量对高危患者进行PAD筛查在今后临床工作中应当成为常规。 慢性肾功能不全者ABI的测量价值 　　　ABI异常对慢性肾功能不全血液透析患者的病死率和心脑血管发病率的预测价值。 　　　 ＡＢＩ小于０.９的血液透析患者全因死亡风险增加４倍，心血管死亡风险增加５.９倍。而ＡＢＩ≥１.３的血液透析患者由于血管钙化和僵硬度增加，全因病死率和心血管死亡风险显著增加。 * PAD: A Call to Action – Contents page The objective of this slide kit is to help primary care physicians (PCPs) recognise PAD and to raise awareness amongst PCPs that PAD is a risk marker for broader, more serious risk; a patient who is diagnosed with PAD is at high risk of life-threatening cardiovascular and cerebrovascular ischemic complications. This slide kit has been developed in response to the ‘PAD Call to Action’ Paper.1 The paper was written by a group of medical experts who wanted to extend this important message about PAD to the broad medical community. This slide kit aims in particular to put into action four of the items called for in this paper: Increase awareness of PAD and its consequences (serious future cardiovascular and cerebrovascular complications) Improve the identification of patients with symptomatic PAD Improve treatment rates among patients who have been diagnosed with symptomatic PAD Increase the rates of early detection among the asymptomatic population. Reference: Belch JJ et al. Critical issues in peripheral arterial disease detection and management. Arch Intern Med 2003; 163: 884–892. * * * Case study discussion points How could this patient be managed differently (considering the potential risk for future cardio