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Buerger disease

最后审阅: 18 Sep 2026
最后更新: 10 Feb 2026

小结

定义

病史和体格检查

其他诊断因素

  • paresthesias/cold sensation/cyanosis in limb or finger
  • ulceration/gangrene
  • claudication
  • rest pain
  • superficial thrombophlebitis
  • cold limb or finger
  • pale limb or finger
  • absence of distal pulses
  • positive Allen test
  • joint arthritis
  • duration of joint symptoms up to 2 weeks
完整详情

危险因素

  • smoking
  • age <40 years
  • region of origin: southeast Mediterranean, Middle East, and Far East
  • male sex
  • periodontal infection
  • human leukocyte antigen (HLA) haplotypes
完整详情

诊断性检查

首要检查

  • blood glucose
  • BUN
  • serum creatinine
  • complete blood count (CBC) with differential
  • coagulation screen
  • thrombophilia screen
  • C-reactive protein (CRP)
  • erythrocyte sedimentation rate (ESR)
  • arterial Doppler
完整详情

需考虑的检查

  • antinuclear antibody
  • rheumatoid factor
  • antineutrophilic cytoplasmic antibody (ANCA)
  • complement levels
  • anticentromere antibody
  • topoisomerase I antibodies (Scl-70)
  • echocardiogram
  • arterial duplex
  • digital subtraction angiography
  • CT angiography
  • magnetic resonance angiography
  • tissue biopsy
  • anticardiolipin antibodies
完整详情

新兴检查

  • genetic testing

治疗流程

急症处理

critical ischemia

持续性治疗

noncritical ischemia

撰稿人

作者

Matthew J. Metcalfe, MD, FRCS, FEBVS, FHEA
Matthew J. Metcalfe

Consultant Vascular Surgeon

Lister Hospital

East and North Hertfordshire NHS Trust

Hertfordshire and West Essex Vascular Network

Hertfordshire

UK

利益声明

MJM declares that he has no competing interests.

Alun H. Davies, MA, DM, FRCS, FHEA
Alun H. Davies

Professor of Vascular Surgery and Honorary Consultant Surgeon

Department of Vascular Surgery

Faculty of Medicine

Imperial College of Medicine

Charing Cross Hospital

London

UK

利益声明

AHD declares that he has no competing interests.

同行评议者

Kosmas I. Paraskevas, MD, FASA

Department of Vascular Surgery

Red Cross Hospital

Athens

Greece

利益声明

KIP declares that he has no competing interests.

Maureen K. Sheehan, MD

Assistant Professor of Surgery

Division of Vascular Surgery

University of Texas Health Science Center at San Antonio

San Antonio

TX

利益声明

MKS declares that she has no competing interests.

Peter F. Lawrence, MD

Chief of Vascular Surgery

Director

Gonda Vascular Center

David Geffen School of Medicine at UCLA

Los Angeles

CA

利益声明

PFL declares that he has no competing interests.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

参考文献

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

关键文献

Le Joncour A, Soudet S, Dupont A, et al. Long-term outcome and prognostic factors of complications in thromboangiitis obliterans (Buerger's disease): a multicenter study of 224 patients. J Am Heart Assoc. 2018 Dec 4;7(23):e010677.全文  摘要

Olin JW, Young JR, Graor RA, et al. The changing clinical spectrum of thromboangiitis obliterans (Buerger's disease). Circulation. 1990 Nov;82(5 suppl):IV3-8. 摘要

Ohta T, Ishioashi H, Hosaka M, et al. Clinical and social consequences of Buerger disease. J Vasc Surg. 2004 Jan;39(1):176-80. 摘要

Cacione DG, Macedo CR, do Carmo Novaes F, et al. Pharmacological treatment for Buerger's disease. Cochrane Database Syst Rev. 2020 May 4;5:CD011033.全文  摘要

参考文献

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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