| 特集名 | 透析患者のスクリーニング検査 -- 透析合併症の防止と健診 | |
|---|---|---|
| 題名 | 透析患者にとって重要となるスクリーニング (2) 末梢動脈疾患（PAD） | |
| 発刊年月 | 2009年 02月 | |
| 著者 | 佐藤 元美 | 社会保険中京病院腎・透析科 |
| 著者 | 天野 泉 | 先進医工学治療研究所 |
| 【 要旨 】 | 末梢動脈疾患（PAD）は，長期・高齢・糖尿病透析患者の増加とともに急増してきた透析合併症の一つである．しかも，虚血の重症度が高く他の心血管系疾患を高率に合併しており，患者予後はきわめて不良である．そのためPADの早期診断・治療が重要となる． PADスクリーニングとしては，足関節上腕血圧比測定が簡便で有用性が高い．しかしながら，透析患者では血管石灰化や末梢病変が多く，足趾上腕血圧比や皮膚灌流圧，血管エコーなど複数の検査を組み合わせ総合的に評価する必要がある． 早期発見のためには確実な「問診」「視診」「触診」が必須であり，複数のスクリーニング検査とそれらの適切な評価によりPAD診断率が高まる． |
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| Theme | Preventive Medical Screening and Health Check-ups for Dialysis patients | |
|---|---|---|
| Title | Screening for peripheral arterial disease | |
| Author | Motoyoshi Sato | Department of Kidney and Dialysis, Social Insurance Chukyo Hospital |
| Author | Izumi Amano | Research Institute of Advanced Therapeutics andEngineering |
| [ Summary ] | Peripheral arterial disease（PAD）is one of the complications whose incidence has been rising along with the sharply increasing number of elderly, diabetic or long term dialysis patients. Evidence of PAD suggests a very poor prognosis because of the high severity of ischemia and high rates of complications due to other cardiovascular disease. Therefore, early diagnosis and treatment is of critical importance to PAD care. The measurement of ankle brachial pressure index is easy and useful as a screening test for PAD. In dialysis patients vascular calcification and/or arteriosclerotic lesions of peripheral arteries below the knee are frequently seen. As aresult, it is necessary to evaluate the disease by combining multiple examinations such as toe brachial pressure index, skin perfusion pressure, and vascular ultrasonography. Reliable histories, inspections, and palpitationare indispensable to early detection of PAD. Rates of correct diagnoses for PAD can be increased through multiple screening examinations and appropriate evaluation of results. |
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