重视下肢动脉病变的诊治是降低糖尿病截肢率的重要措施

Attention to the diagnosis and treatment of peripheral artery disease is essential in reducing diabetic foot ulcer and amputation

下肢动脉疾病（PAD）是常见的糖尿病并发症，具有多节段、更远端、病变更广泛等临床特点。该症起病缓慢而隐匿，临床上尚末受到足够重视，但危害性大，是糖尿病足的重要原因。该症诊断相对容易，触诊、踝肱动脉压指数测定、皮温测定、超声检查、CT或核磁共振都是有效的诊断技术，血管减数造影仍然是诊断的金标准。轻一中度病变采用药物治疗，重症患者需要外科手术治疗。介入治疗如深部球囊扩张术和血管内支架置放和干细胞移植治疗已在国内一些大医院开展并取得了相当疗效。

Peripheral artery disease （PAD） is one of diabetic macrovascular complications, with characteristics of being more distal, segmental and extensive. The clinical manifestation of PAD is usually not noticed, and thus diagnosis easily missed. However, PAD is a main cause of diabetic foot and amputation, which would be diagnosed relatively easily if due attention is paid to artery pulse, ankle-brachial blood pressure index, and skin temperature. Ultrasound, CT, MR, and digital subtraction angiography （DSA） examinations are quite useful tools in diagnosis of PAD. The treatment of PAD, including medical and surgical intervention, has been developing quickly. Therapy with stem cell transplantation has been tested in some clinics.