外周动脉疾病
手臂动脉疾病或, Peripheral arterial disease (PAD) occurs when plaque builds up on the inside walls of the arteries that carry blood from the heart to the head, 内部器官, 和四肢. PAD is also known as atherosclerotic peripheral arterial disease.
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症状
At least half of the people who have peripheral arterial disease (PAD) don't have any signs or symptoms of the disease. People who do have signs or symptoms may have pain when walking or climbing stairs, 休息后哪一个可以缓解. 这种疼痛被称为间歇性跛行. Blood brings oxygen to the muscles, but during exercise, muscles need more blood flow. If there is a blockage in the blood vessels, muscles won't get enough blood. If a person has intermittent claudication and exercises while in pain, 他或她的肌肉可能会受到伤害. When resting, the muscles require less blood flow and the pain goes away. Claudication is more likely in people who also have atherosclerosis in other arteries, 比如心脏和大脑. About 10 percent of people with PAD have intermittent claudication.
PAD的其他体征和症状包括:
- Pain, numbness, aching, and heaviness in the muscles
- 腿部、大腿、小腿和脚抽筋
- 脉搏跳动腿或脚的脉搏微弱或没有脉搏
- Sores or wounds on toes, feet, or legs that heal slowly, poorly, or not at all
- Color changes in skin, paleness, or blueness (called cyanosis)
- A decreased temperature in one leg compared to the other leg
- Poor nail growth and decreased hair growth on toes and legs
- Erectile dysfunction, especially among people with diabetes
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成因及危险因素
The most common cause of peripheral arterial disease (PAD) is atherosclerosis. When atherosclerosis affects the arteries of the limbs, it is called PAD. The exact cause of atherosclerosis is unknown in the majority of cases. 在动脉粥样硬化, the plaque that builds up on artery walls is made up of fat, 胆固醇, calcium, 以及血液中的其他物质. Smoking, diabetes, 高胆固醇血症, and high blood pressure increase the risk of atherosclerosis.
患PAD的主要危险因素包括:
Smoking. Smoking is more closely related to developing PAD than any other risk factor. Smoking increases the risk of developing PAD three to five times. 平均, smokers who develop PAD experience symptoms 10 years earlier than nonsmokers who develop PAD. 戒烟会减缓PAD的进展. Smoking even one or two cigarettes daily can interfere with the treatment for PAD. Smokers and diabetics have the greatest risk of complications from PAD, including gangrene in the leg from decreased blood flow.
慢性或严重的疾病，如糖尿病. One in three people over age 50 with diabetes is likely to have PAD. Anyone over age 50 with diabetes should be screened for PAD.
其他疾病和状况，例如:
- 肾脏疾病
- 有Hypertension或家族病史
- A high 胆固醇 level or a family history of it
- 有心脏病或家族病史
- 有中风家族史
- Age: Men who are older than age 50 and women who are older than age 55 are at higher risk for PAD
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外周动脉疾病诊断
Peripheral arterial disease (PAD) is diagnosed based on general medical and family history, 腿部或心脏病史, 个人危险因素, 体检, 测试结果. 准确的诊断至关重要, because people with PAD face a six to seven times higher risk of heart disease or stroke than the rest of the population. PAD is often diagnosed after symptoms are reported. If you have PAD, your doctor also may want to look for signs of coronary artery disease (CAD).
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板药物
药物可用于:
- Lower high 胆固醇 levels and high blood pressure
- Thin the blood to prevent clots from forming due to low blood flow
- 溶解血块
- Help improve pain in the legs that is the result of walking or climbing stairs (claudication)
Some medicines lower the level of low density lipoprotein (LDL) 胆固醇. 低密度脂蛋白是“坏”胆固醇. The higher the LDL level in the blood, the greater the chance of heart disease. 药物可能包括他汀类药物, 比如洛伐他汀, 辛伐他汀, 普伐他汀, fluvastatin, 和阿托伐他汀. Other medicines may include ezetimibe, gemfibrozil, and certain binding agents.
PAD手术或特殊手术
Surgery may be necessary if blood flow in a limb is completely or almost completely blocked. 在搭桥手术中, the doctor uses a blood vessel from another part of your body or a tube made of synthetic (man-made) material to make a graft. This graft bypasses the blockage in the artery, allowing blood to flow around it. Surgery does not cure PAD, but it may increase blood flow to the limb.
Angioplasty may be performed to restore blood flow through a narrowed or blocked artery. 在手术过程中, a thin tube (catheter) is inserted into a blocked artery and a small balloon on the tip of the catheter is inflated. When the balloon is inflated, plaque is pushed against the artery walls. This causes the artery to widen, restoring blood flow. A stent, a tiny mesh tube that looks like a small spring, is now used in most angioplasties. Some stents are coated with medicine to help prevent the artery from closing again.
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