查周围动脉疾病和心血管疾病风险评估与关节指数:美国预防服务工作组建议声明
, Susan J Curry1, Alex H Krist2,3
1University of Iowa, Iowa City.
JAMA
|July 13, 2018
概括
在无症状的成年人中使用脚腕指数 (ABI) 查周围动脉疾病 (PAD) 缺乏足够的证据. 目前尚未确定使用ABI对PAD和心血管疾病 (CVD) 查的益处和危害平衡.
科学领域:
- 血管医学
- 预防性心脏病学
- 诊断准确性的研究
背景情况:
- 周围动脉疾病 (PAD) 是系统性动脉样硬化的下肢表现,增加心血管疾病 (CVD) 的风险.
- 可能导致截肢等严重并发症.
- 查PAD和心血管疾病风险对于早期干预至关重要.
研究的目的:
- 更新2013年美国预防服务工作组 (USPSTF) 关于使用脚-手臂指数 (ABI) 进行PAD和CVD风险查的建议.
- 对包括糖尿病在内的无症状成年人ABI查的益处和危害的证据进行评估.
- 评估监督运动和物理治疗对PAD结果的影响.
主要方法:
- 在无症状成年人中对PAD和CVD风险的ABI查证据的系统审查.
- 包括对糖尿病患者和基于运动的干预措施的研究.
- 对查准确性,治疗益处和潜在危害的数据进行分析.
主要成果:
- 有限的数据存在于ABI的准确性识别无症状个体谁会从PAD或CVD治疗受益.
- 在未经选择的人群中,ABI导向的阿司匹林治疗或运动治疗没有显著的益处.
- 没有直接针对查危害的研究,但存在过度诊断和标记的可能性.
结论:
- 目前的证据不足以确定在无症状成年人中查PAD和CVD风险的益处与危害的平衡.
- 美国PSTF认为证据不足 (I声明).
- 需要进一步的研究来澄清ABI查在预防性心血管治疗中的作用.
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