外周动脉疾病抗血栓治疗.pptVIP

西洛他唑可提高PAD患者步行距离 J Am Geriatr Soc 2000;50:1939–1946 6项研究的荟萃分析 J Am Geriatr Soc 2000;50:1939–1946 P0.0001 P0.0001 P0.0001 P0.0001 最大步行距离 步行距离 步行速度 健康状况 西洛他唑 安慰剂 提高率（%） 40 20 34 21 21 8 5 0 运动康复训练疗效优于西洛他唑 -----ACCP8 在轻度间歇性跛行患者中应用西洛他唑对 于延长步行距离的作用甚至不及运动康复 训练，因此西洛他唑在轻度间歇性跛行患 者中的应用受到质疑。 -----2008ACCP8 指南对西洛他唑的使用建议 更趋严格 对中重度间歇性跛行患者，如果保守治疗无效（改变 危险因素或运动疗法）而且没有外科手术或导管介入 治疗的指征，建议应用西洛他唑（1A）。对轻度间歇 性跛行患者，不建议应用西洛他唑（2A）。 -----2008ACCP8 目 录 PAD— 严重危害人类健康的疾病 抗血小板治疗是防治PAD 的重要措施 PAD抗血小板治疗— 循证与指南 小结 小 结 阿司匹林75~100mg/d ，适用于绝大多数PAD患者。 阿司匹林不能耐受者，建议使用氯吡格雷替代。 中重度间歇性跛行患者（保守治疗无效，无手术指征者）西洛他唑可改善症状。 PAD严重威胁人类健康 Felix Hoffman 阮玲玉 John Vane 西欧和北美有近3000万人患PAD，在高危人群中PAD的发病率近20-30%1,3我国PAD也有相当大的人群，北京市60岁以上的老年人，外周动脉疾病患者约为1/5 2,3 Heart 2007;93;303-308 Recent estimates suggest that nearly 30 million people are affected by peripheral arterial disease (PAD) in North America and Western Europe.1 In older patients, or those with risk factors such as diabetes mellitus or smoking, the prevalence of PAD approaches 20–30% Prevalence of peripheral arterial disease and its association with smoking in a population-based study in Beijing, China Journal of Vascular Surgery. 44(2):333-338, August 2006. He, Yao MD, PhD a,b; Jiang, Yong MD a; Wang, Jie MD, PhD c; Fan, Li MD d; Li, XiaoYing MD d; Hu, Frank B. MD, PhD b Objective: Although the prevalence of peripheral arterial disease (PAD) and its association with smoking in Western populations has been extensively studied, little information is available in China. The objective of this study was to determine the age-standardized prevalence of PAD and examine the relationship between smoking, quitting, and PAD in elderly Chinese.Methods: We conducted a population-based cross-sectional study in an urban Beijing sample of 2334 subjects aged =60 years (943 men and 1391 women) in 2001 to 2002. PAD was assessed by symptoms of intermittent claudication (IC) as measured by the