硬化闭塞症.ppt

All patients who smoke should be strongly and repeatedly advised to stop smoking * A more recent meta-analysis of statin therapy concluded that in a broad spectrum of patients, a 1 mmol/L (38.6 mg/dL) reduction in LDL cholesterol level was associated with a 20% decrease in the risk of major cardiovascular events. * Thiazide diuretics are first-line agents, angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers should be used in patients with diabetic renal disease or in congestive heart failure, and calcium channel blockers for difficult to control hypertension. Beta-adrenergic blocking drugs have previously been discouraged in PAD because of the possibility of worsening claudication symptoms. However, this concern has not been borne out by randomized trials; therefore, beta-adrenergic-blocking drugs can be safely utilized in patients with claudication * the United States Federal Drug Administration has now approved ramipril for its cardioprotective benefits in patients at high risk, including those with PAD. Thus, in terms of a drug class, the ACE inhibitors would be recommended in patients with PAD. * * 匹格列酮—激活脂肪，骨骼肌肉和肝脏等胰岛素所作用的组织过氧化物增值体激活受体。 * FIGURE 2D. Runoff of the left leg shows no superficial femoral or popliteal artery. There was only collateral flow (arrow) from the thigh to the calf. * Side effects included headache, diarrhea, and palpitations. * . Cilostazol (100 mg orally 2 times per day) is indicated as an effective therapy to improve symptoms and increase walking distance in patients with lower extremity PAD and intermittent claudication (in the absence of heart failure). 2. A therapeutic trial of cilostazol should be considered in all patients with lifestyle-limiting claudication (in the absence of heart failure). * 萘呋胺 * Objective hemodynamic parameters that support the diagnosis of critical limb ischemia include an ankle-brachial index of 0.4 or less, an ankle systolic pressure of 50 mm Hg or less, or a toe systolic pre