临床检查是否预测下肢外周动脉疾病?
Nadia A Khan1, Sherali A Rahim, Sonia S Anand
1Department of Medicine, University of British Columbia, Vancouver, Canada. nakhan@shaw.ca
JAMA
|February 2, 2006
概括
对外围动脉疾病 (PAD) 的临床检查是有用的,但不是最终的. 使用手持多普勒仪的PAD查得分为这种常见疾病提供了最大的诊断准确度.
科学领域:
- 血管医学 血管医学
- 诊断的准确性 诊断的准确性
- 临床检查 临床检查
背景情况:
- 周围动脉疾病 (PAD) 是一种普遍的疾病,与增加的发病率和死亡率有关.
- 医生依靠临床检查来确定需要进一步诊断PAD测试的患者.
研究的目的:
- 系统地审查诊断PAD的临床检查的准确性和精确性.
- 评估各种体检发现和患者病史元素的诊断效用.
主要方法:
- 在MEDLINE和Cochrane数据库中进行了全面的文献搜索,以寻找通过体检诊断PAD的研究.
- 包括的研究将临床发现与参考标准进行比较,例如脚-手腕指数,双重声谱或血管学.
- 数据提取和质量审查由两位作者独立进行.
主要成果:
- 对于无症状的患者来说,,大腿和脉异常是PAD的关键指标.
- 在症状患者中,皮肤凉爽,和脉异常是重要的诊断发现.
- 没有声或脉异常可以降低PAD的可能性.
- 一个采用手持多普勒仪的PAD评分系统显示出卓越的诊断准确性.
结论:
- 对PAD的临床检查结果应与预测概率一起解释.
- 单个临床发现不足以最终诊断或排除PAD.
- 使用手持多普勒仪的PAD查得分提供了最高的诊断准确度.
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