糖尿病的外周血管病变及处理推荐.ppt

外科治疗 血管搭桥术 支架植入术 截肢 * 重建侧枝循环影响疾病进展重要因素 血管狭窄和闭塞过程中机体伴有侧枝循环形成（时间、条件） 侧枝不能完全改善肢体缺血 能防止肢体出现急性缺血 侧枝循环良好者一般不发生肢端坏疽 侧枝循环形成障碍可导致远端发生坏疽 * 谢谢 * * * 根据之前20年的数据统计及对未来发病率的预测，WHO认为，全球糖尿病的发病率正在不断增加1。 1985年，全球约有3千万人患有糖尿病。1995年增加为13.5千万，2000年则为17.7千万。 WHO预测，至2030年，糖尿病的发病人数将会达到37千万1 。 发展中国家糖尿病的发生率增加，这主要归因于人口的增加、人口老龄化、不健康的饮食、肥胖、久坐的生活方式，以及儿童及青少年2型糖尿病发生率的增加等。WHO提出，未来，发展中国家和发达国家糖尿病的流行情况将会出现显著差异。WHO预测，到2030年，发达国家的大部分糖尿病患者将是65岁或65岁以上的老年人。而发展中国家的糖尿病患者则主要是45-65岁之间的具有劳动能力的中年人1 。 Reference 1. World Health Organization. Diabetes. Global Strategy on Diet, Physical Activity and Health. Available at /hpr/NPH/docs/gs_diabetes.pdf. Accessed February 23, 2004. * In the UKPDS, 50% of patients had a diabetes-related complication at diagnosis.1 Neuropathy affects around 70% of those with diabetes at the time of diagnosis, leading to 55,000–60,000 amputations in the US each year.2 Retinopathy, glaucoma or cataracts occur in around 10% of people after 15 years of diabetes. Blindness affects around 2%.2 Nephropathy is the leading cause of end-stage renal disease.2 Coronary heart disease (CHD) affects 7.5–20% of all people with diabetes over 45 years of age in the US. The risk of CHD is two to four times higher than for those without diabetes.2 Cerebrovascular disease: the risk of stroke is two to four times higher in people with diabetes. Fifteen percent of people with type 2 diabetes die from stroke.2 The risk of peripheral vascular disease is four to eight times higher in people with type 2 diabetes.2 1. UKPDS Group. UKPDS 33. Lancet 1998; 352:837–853. 2. World Health Organization/International Diabetes Federation. The economics of diabetes and diabetes care: a report of the Diabetes Health Economics Study Group. 1999 (WHO). * Atherothrombosis: a Generalized and Progressive Process Atherothrombosis is the common underlying disease process for MI, ischemia and vascular death. ACS are classic examples of atherothrombosis (plaque rupture and thrombus f