Circulation:微血管疾病和外周动脉疾病均可显著增加截肢风险

2019-08-14 MedSci MedSci原创

与周围动脉疾病相关的肢体不良事件的机制仍不完全清楚。微血管疾病是否与截肢有关?研究人员对此展开研究。退伍军人老龄化队列研究于2003年4月1日-2014年12月31日期间招募的受试者。排除有下肢截肢史的个体。采用时间更新的Cox比例危险回归分析流行的微血管疾病(视网膜病变、神经病变和肾病)和周围动脉疾病状态对截肢风险的影响。在125 674名起始无截肢的退伍军人中,中位随访9.3年,截肢率为1.1

与周围动脉疾病相关的肢体不良事件的机制仍不完全清楚。微血管疾病是否与截肢有关?研究人员对此展开研究。

退伍军人老龄化队列研究于2003年4月1日-2014年12月31日期间招募的受试者。排除有下肢截肢史的个体。采用时间更新的Cox比例危险回归分析流行的微血管疾病(视网膜病变、神经病变和肾病)和周围动脉疾病状态对截肢风险的影响。

在125 674名起始无截肢的退伍军人中,中位随访9.3年,截肢率为1.16例/1000人年,共1185例截肢。在实时更新的多变量校正分析中,与无外周动脉疾病或微血管疾病的患者相比,仅有微血管疾病的个体截肢风险增加了3.7倍(95% CI, 3.0-4.6);仅有外周动脉疾病的个体截肢风险增加了13.9倍(95% CI, 11.3-17.1);同时患有两种疾病的个体的截肢风险增加了22.7倍(95% CI, 18.3–28.1) 。

与传统的危险因素无关,微血管疾病可单独增加截肢的风险,并协同增加周围动脉疾病患者的截肢风险。需进一步的研究来了解这种现象发生的机制。


原始出处:

Joshua A. Beckman,et al.Microvascular Disease, Peripheral Artery Disease, and Amputation. Circulation. 2019;140:449–458. https://doi.org/10.1161/CIRCULATIONAHA.119.040672

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    2019-08-16 mgqwxj
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