Patients with arteriosclerosis obliterans, or peripheral arterial disease
have been conventionally diagnosed and treated from only the viewpoint
of peripheral arterial circulation. These concepts may have improved the
quality of life for patients, but could not contribute the prognosis of
life, because peripheral arterial disease is associated with an increased
risk of the coronary disease and cerebrovascular disease.
Intermittent claudication, the most common symptom of peripheral arterial
disease, results from flowreducing lesions in the arteries of the lower
extremity that cause exercise-induced muscle ischemia. In order to evaluate
intermittent claudication, many kinds of noninvasive diagnostic studies,
including ABPI(ankle brachial pressure index) and the measurement of claudication
distance, et al have been proposed. We have used the recovery time of the
ischemic reaction at foot sole, plethysmography, thermography, laser doppler
flowmetry, or NIRS(near-infrared spectroscopy) after walking test, rather
than ABPI. These examinations will be superior to ABPI to evaluate effects
after ergotherapy or pharmacotherapy for patients with intermittent claudication.
Carotid artery sclerosis may be a good marker of systemic atherosclerosis. By our assessment of risk factors, the progression of atherosclerotic change in carotid artery was strongly correlated with two risk factors, such as smoking and systolic blood pressure. In the cholesterol analysis, Lp(a) was only high risk factor for atherosclerotic change of carotid artery.
Recent technical advances, adequate evaluation of systemic atherosclerosis,
and reduction of risk factors should improve the prognosis of patients
with peripheral arterial disease.
[Rinsho Byori 50 : 802～806, 2002]
*1The Institute for Clinical Research, National Kanazawa Hospital, Kanazawa 920-8650
【Key Words】arteriosclerosis obliterans(閉塞性動脈硬化症)，peripheral arterial disease(末梢動脈閉塞症)，systemic atherosclerosis(多発型動脈硬化症)，functional test for peripheral circulation(末梢循環機能測定法)，carotid atherosclerosis (頸動脈アテローム硬化症)，lipoprotein(リポ蛋白)
*1,2国立金沢病院臨床研究部(〒920-8650 金沢市下石引町1-1)
E-mail :sasaki@kibyou.hosp.go.jp