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Circulation:缺血性脑卒中患者外周动脉事件发生率、危险因素及预后

2015-09-11 崔倩 译 MedSci原创

目前公布的关于严重肢体缺血(CLI),急性肢体缺血(ALI)或急性内脏缺血(AVI)的数据,研究人员用来告知卫生服务规划,监测预防和风险预测。在一项以人口为基础的研究中(英国牛津郡,2002年至2012年),研究人员确定了92728名参与者所有急性外周动脉事件和结果。风险因素通过与基础总体比较进行了评估。510例急性事件发生在386例患者中,需要803项干预。研究包含221(59.3%)例年龄≥7

目前公布的关于严重肢体缺血(CLI)、急性肢体缺血(ALI)或急性内脏缺血(AVI)的数据,研究人员用来告知卫生服务规划,监测预防和风险预测。

在一项以人口为基础的研究中(英国牛津郡,2002年至2012年),研究人员确定了92728名参与者的所有急性外周动脉事件和结果。风险因素通过与基础总体比较进行了评估。在386例患者中发生了510例急性事件,需要803项干预。研究包含221(59.3%)例年龄≥75岁的患者和98例(26.3%)≥85岁的患者。230(62.3%)例患者与之前事件相互独立,但270例(73.4%)在6个月的随访随访过程中死亡或有依赖性;在5年时,328(88.9%)例患者死亡或有依赖性。相对于ALI(75.3%)和CLI(92.6%),AVI的30天存活率最低(28.2%)(P<0.001)。危险因素(所有P<0.001)是高血压(年龄性别调整 RR 2.75,1.95-3.90)、吸烟(2.14,1.37-3.34)和糖尿病(3.01,1.69-5.35;特别是对于CLI(5.96,3.15-11.26)。288(77.2%)例患者有已知的的心血管疾病,361例患者(96.8%)有血管危险因素,但只有203例患者(54.4%)与一种抗血小板药物相关,只有166(44.5%)例患者与一种他汀类药物相关。虽然260(69.7%)例患者服用抗高血压药物,但42.9%的患者在事件发生前5年中所有BPs记录>140/90。88(23.6%)例患者患者发生心源性栓塞事件,62例发生已知的AF事件(事件发生前诊断),其中只有14.5%进行了抗凝治疗,尽管82.3%患者CHA2DS2VASC分数≥2并且无禁忌。

外周动脉事件的临床负担是巨大的。虽然已经知道绝大多数在其他地区的患者的血管疾病和多种治疗的风险因素,但病前的控制还是较差的。

原始出处:

Dominic P.J. Howard,Amitava Banerjee,Jack F. Fairhead,et al.A Population-Based Study of Incidence, Risk Factors, Outcome and Prognosis of Ischaemic Peripheral Arterial Events,Circulation,2015.9.8

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