美国预防服务工作组关于查外围动脉疾病的建议声明:伤害超过益处?
Joshua A Beckman1, Michael R Jaff, Mark A Creager
1Cardiovascular Division, Brigham and Women's Hospital, Boston, Mass, USA. jbeckman@partners.org
美国预防服务工作组建议不要对外围动脉疾病 (PAD) 进行查. 这篇评论认为,PAD查对早期检测和预防心血管事件有益.
科学领域:
- 血管医学 血管医学
- 预防性心脏病学 预防性心脏病学
- 公共卫生政策 公共卫生政策
背景情况:
- 美国预防服务工作组 (USPSTF) 更新了其1996年关于周围动脉疾病 (PAD) 查的建议.
- 美国PSTF分配了一个"D"建议,建议不要进行PAD查,因为感知到的益处和潜在危害最小.
研究的目的:
- 为了质疑USPSTF反对PAD查的建议.
- 突出早期PAD检测和治疗降低心血管风险的好处.
主要方法:
- 对USPSTF声明和支持同行评审文献的批判性审查.
- 对PAD患病率,查有效性和患者预后的分析.
主要成果:
- 美国PSTF声明遗漏了关于PAD流行,查有效性和不良预后的关键数据.
- 大多数PAD患者无症状,但患有心血管事件 (心肌梗塞,中风,死亡) 的风险很高.
- 药物治疗显著降低了PAD患者的发病率和死亡率.
结论:
- 美国PSTF对PAD查的"D"建议可能导致诊断不足和治疗不足.
- 早期发现和治疗PAD对于预防心血管不良后果至关重要.
- 美国PSTF应该重新评估数据,并纳入血管专业知识.
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