{{위키데이터 속성 추적}}
{{질병 정보 (신규)
 | 이름           = 말초동맥질환
 | 그림           = Arterial ulcer peripheral vascular disease.jpg
 | 그림설명       = 
}}
'''말초동맥질환'''(末梢動脈疾患, {{lang|en|peripheral artery disease}}, PAD)은 [[심장]]이나 [[뇌]]를 공급하는 동맥 외에 [[동맥]]이 좁아지는 질환이다.<ref name=Heart2012>{{웹 인용|title=What Is Peripheral Vascular Disease?|url=https://www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300323.pdf|website=https://www.heart.org|accessdate=26 February 2015|date=2012|보존url=https://web.archive.org/web/20150412121230/http://www.heart.org/idc/groups/heart-public/%40wcm/%40hcm/documents/downloadable/ucm_300323.pdf|보존날짜=2015-04-12|url-status=dead}}</ref> 심장 내에서 좁아지는 질환은 [[관상동맥질환]]이라 부르며, 뇌에서 좁아지는 경우 [[뇌혈관 질환]]이라 부른다. 말초동맥질환은 대개 [[다리]]에 영향을 미치지만 다른 동맥이 수반될 수도 있다.<ref name=HLB2011W>{{웹 인용|title=What Is Peripheral Arterial Disease?|url=http://www.nhlbi.nih.gov/health/health-topics/topics/pad|website=http://www.nhlbi.nih.gov/|accessdate=25 February 2015|date=August 2, 2011}}</ref>

== 증상 ==
[[파일:Peripheral vascular disease video.webm|섬네일|upright=1.4|동영상 설명]]
말초동맥질환 환자들 가운데 50%는 증상이 없다.<ref name=Vio2012>{{저널 인용|last1=Violi|first1=F|last2=Basili|first2=S|last3=Berger|first3=JS|last4=Hiatt|first4=WR|title=Antiplatelet therapy in peripheral artery disease.|journal=Handbook of experimental pharmacology|date=2012|issue=210|pages=547–63|pmid=22918746|doi=10.1007/978-3-642-29423-5_22}}</ref> 다리와 발에 대한 말초동맥질환의 증상은 일반적으로 2가지 분류로 나눌 수 있다:

# [[간헐성파행증]]
# [[중증하지허혈]]
:* [[중증하지허혈|휴식통]]
:* [[중증하지허혈|조직 소실]]

== 병인 ==
말초동맥질환에 기여하는 위험 요인은 [[죽상동맥경화증]]과 동일하다:<ref name=Merck>{{MerckManual|07|080|f||Peripheral Arterial Disease}}. Retrieved August 9, 2010.</ref><ref name="Joosten MM 2012">{{저널 인용 |vauthors=Joosten MM, Pai JK, Bertoia ML, Rimm EB, Spiegelman D, Mittleman MA, Mukamal KJ | date = Oct 2012 | title = Associations between conventional cardiovascular risk factors and risk of peripheral artery disease in men | url = | journal = JAMA | volume = 308 | issue = 16| pages = 1660–7 | doi = 10.1001/jama.2012.13415 | pmid = 23093164 }}</ref>
* 흡연
* [[당뇨병]]
* [[이상지질혈증]]
* [[고혈압]]
* 50대 이상의 남성의 [[비만]], [[심근 경색]], [[뇌졸중]]<ref>Selvin E, Erlinger TP: Prevalence of and risk factors for peripheral arterial disease in the united states results from the national health and nutrition examination survey, 1999–2000. ''Circulation'' 2004, 110(6):738-743.</ref><ref>{{저널 인용 |vauthors=Hooi JD, Kester AD, Stoffers HE, Overdijk MM, van Ree JW, Knottnerus JA | year = 2001 | title = Incidence of and risk factors for asymptomatic peripheral arterial occlusive disease: a longitudinal study | url = | journal = American Journal of Epidemiology | volume = 153 | issue = 7| pages = 666–672 | doi=10.1093/aje/153.7.666 | pmid=11282794}}</ref> 또는 [[관다발병]]의 가족력.<ref>{{저널 인용 |vauthors=Allison MA, Denenberg JO, Criqui MH | year = 2011 | title = Family History of Peripheral Artery Disease Is Associated With Prevalence and Severity of Peripheral Artery Disease | url = | journal = Journal of the American College of Cardiology | volume = 58 | issue = 13 | doi = 10.1016/j.jacc.2011.06.023 | pmid = 21920269 | pages=1386–92}}</ref><ref>{{저널 인용 |vauthors=Valentine RJ, Guerra R, Stephan P, Scoggins E, Clagett GP, Cohen J | year = 2004 | title = Family history is a major determinant of subclinical peripheral arterial disease in young adults | url = | journal = Journal of vascular surgery | volume = 39 | issue = 2| pages = 351–356 | doi=10.1016/j.jvs.2003.07.011}}</ref>
* C 반응성 단백질 피브리노겐<ref>{{저널 인용 |vauthors=Ridker PM, Stampfer MJ, Rifai N | year = 2001 | title = Novel risk factors for systemic atherosclerosis | url = | journal = JAMA: the journal of the American Medical Association | volume = 285 | issue = 19| pages = 2481–2485 | doi=10.1001/jama.285.19.2481}}</ref>, [[과점도 증후군|과점도]], [[혈전성향증]]

== 진단 ==
=== 분류 ===
일반적으로 말초동맥질환은 René Fontaine이 1954년 만성 팔다리 [[허혈]]을 위해 도입된 퐁텐 단계로 나눌 수 있다.<ref name="TASC2">TASC II Guidelines<br />* {{저널 인용 |author=Norgren L, Hiatt WR, Dormandy JA|journal=Eur J Vasc Endovasc Surg. |volume=33 |issue=Suppl 1 |title=Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II) |pages=S1–75 |year=2007 |pmid=17140820 |doi=10.1016/j.ejvs.2006.09.024 |display-authors=2|last2=Hiatt |last3=Dormandy |last4=Nehler |last5=Harris |last6=Fowkes |last7=Tasc Ii Working |last8=Bell |last9=Caporusso |last10=Durand-Zaleski |last11=Komori |last12=Lammer |last13=Liapis |last14=Novo |last15=Razavi |last16=Robbs |last17=Schaper |last18=Shigematsu |last19=Sapoval |last20=White |last21=White |last22=Clement |last23=Creager |last24=Jaff |last25=Mohler e |last26=Rutherford |first26=Robert B.|last27=Sheehan |last28=Sillesen |last29=Rosenfield }}<br />* {{저널 인용 |author=Norgren L |title=Inter-Society Consensus for the Management of Peripheral Arterial Disease (TASC II) |journal=J Vasc Surg. |volume=45 |issue=Suppl S |pages=S5–67 |year=2007 |pmid=17223489 |doi=10.1016/j.jvs.2006.12.037 |name-list-format=vanc|author2=Hiatt WR |author3=Dormandy JA |author4=TASC II Working Group |display-authors=4 |last5=Harris |first5=K.A. |last6=Fowkes |first6=F.G.R. |last7=Tasc Ii Working |first7=Group}}<br />* {{저널 인용 |vauthors=Norgren L, Hiatt WR, Dormandy JA |title=Inter-Society Consensus for the Management of Peripheral Arterial Disease |journal=Int Angiol. |volume=26 |issue=2 |pages=81–157 |year=2007 |pmid=17489079 |doi= }}</ref><ref>{{저널 인용 | author=Fontaine R, Kim M, Kieny R | title=Die chirugische Behandlung der peripheren Durchblutungsstörungen. (Surgical treatment of peripheral circulation disorders) | journal=Helvetica Chirurgica Acta | year=1954 | volume=21 | issue=5/6 | pages=499–533 |language=독일어| pmid=14366554| last2=Kim | last3=Kieny }}</ref>
* 단계 I: 무증상. 불완전한 혈관 방해
* 단계 II: 팔다리에 낮은 [[절뚝거림]] 통증
:* 단계 IIA: 200미터 이상의 거리를 걸을 때 절뚝거림
:* 단계 IIB: 200미터 미만의 거리를 걸을 때 절뚝거림
* 단계 III: [[휴식통]], 주로 발에.
* 단계 IV: 팔다리의 [[괴사]] 및 [[괴저]]

== 치료 ==
질병의 심각성에 따라 다음의 단계를 따를 수 있다.<ref name=PMID12637405>{{저널 인용 |author=Burns P, Gough S, Bradbury AW |title=Management of peripheral arterial disease in primary care |journal=BMJ |volume=326 |issue=7389 |pages=584–8 |date=March 2003 |pmid=12637405 |pmc=1125476 |doi=10.1136/bmj.326.7389.584|last2=Gough |last3=Bradbury }}</ref>
=== 생활 양식의 변화 ===
* [[금연]]
* 당뇨병 관리
* 고혈압 관리
* 고칼레스테롤 관리 및 [[항혈소판제]] 복용.
* 정기적인 운동.
=== 약물 ===
[[실로스타졸]]이나 [[펜톡시필린]]은 일부분 증상을 개선할 수 있다.<ref>{{저널 인용 |author=Robless P, Mikhailidis DP, Stansby GP |title=Cilostazol for peripheral arterial disease |journal=Cochrane Database Syst Rev |volume= |issue=1 |pages=CD003748 |year=2008 |pmid=18254032 |doi=10.1002/14651858.CD003748.pub3 |url= |editor1-last=Robless |editor1-first=Peter|last2=Mikhailidis |last3=Stansby }}</ref><ref>{{저널 인용|last1=Salhiyyah|first1=Kareem|last2=Senanayake|first2=Eshan|last3=Abdel-Hadi|first3=Mohammed|last4=Booth|first4=Andrew|last5=Michaels|first5=Jonathan A|editor1-last=Salhiyyah|editor1-first=Kareem|title=Pentoxifylline for intermittent claudication|journal=Cochrane Database of Systematic Reviews|volume=1|pages=CD005262|year=2012|pmid=22258961|doi=10.1002/14651858.CD005262.pub2|type=Systematic Review}}</ref>

== 각주 ==
{{각주|30em}}

== 외부 링크 ==
{{Medical resources
|  DiseasesDB     = 31142
|  ICD10          = {{ICD10|I|73|9|i|70}}
|  ICD9           = {{ICD9|443.9}}
|  ICDO           =  
|  OMIM           =  
|  MedlinePlus    = 000170
|  eMedicineSubj  = med
|  eMedicineTopic = 391
|  eMedicine_mult = {{eMedicine2|emerg|862}}
|  MeshID         = D016491
}}


* {{저널 인용|last1=Gerhard-Herman|first1=Marie D.|last2=Gornik|first2=Heather L.|last3=Barrett|first3=Coletta|last4=Barshes|first4=Neal R.|last5=Corriere|first5=Matthew A.|last6=Drachman|first6=Douglas E.|last7=Fleisher|first7=Lee A.|last8=Fowkes|first8=Francis Gerry R.|last9=Hamburg|first9=Naomi M.|last10=Kinlay|first10=Scott|last11=Lookstein|first11=Robert|last12=Misra|first12=Sanjay|last13=Mureebe|first13=Leila|last14=Olin|first14=Jeffrey W.|last15=Patel|first15=Rajan A.G.|last16=Regensteiner|first16=Judith G.|last17=Schanzer|first17=Andres|last18=Shishehbor|first18=Mehdi H.|last19=Stewart|first19=Kerry J.|last20=Treat-Jacobson|first20=Diane|last21=Walsh|first21=M. Eileen|display-authors=5|title=2016 AHA/ACC Guideline on the Management of Patients With Lower Extremity Peripheral Artery Disease: Executive Summary|journal=Circulation|date=13 November 2016|pages=CIR.0000000000000470|doi=10.1161/CIR.0000000000000470}}

{{전거 통제}}

[[분류:동맥, 세동맥 및 모세혈관 질환]]