| Diabetes mellitus (DM), which takes the sugar metabolic disorder as its main performance is a group of clinical syndrome caused by the genetic and environmental factors. With the aging of population in the the modern society, the incidence of DM is increasing year by year around the world. There are more than 15 million diabetic patients in the whole world and the incidence of diabetes take the second place in the whole world at present. One of the troubled matters with DM is that there are various kinds of chronic complications.The lower extremity arterial disease (LEAD), also called peripheral arterial disease(PAD), which may cause death and disability is one of the serious chronic complicationsis of DM. With the development of DM, The occurrence probability of PAD increases significantly which is 5-10 times more than the healthy adults. Because the rapid development of LEAD decreases life's time and quality of patient, therefore, LEAD should be diagnosed early and treated effectively.Lower extremity arterial disease(PAD) is a serious chronic complication in type 2 diabetes mellitus, which badly affects our life quality. It is of great significance to discover and prevent PAD earlier because it is the major reason for diabetic foot ulcer, lower limb amputation, and especially high level amputation and second amputation. Ankle-brachial index (ABI), also named as ankle brachial pressure index, refers to the ratio of the systolic pressure in lower limb ankle part to that of the upper arm with its sensitivity and sepecitity reaching 95% and almost 100% respecitvely. ABI is a cheap harmless reliable index of PAD because most PAD patients don't show recognizable ischemic limb symptoms. So with the mesurement of ABI, we can detect whether 2 diabetes mellitus patients also suffer from PAD, which should be widly applied to clinic. The forming mechanism of PAD is very complicated, which is commonly believed to be led to by the cooperation of many factors. In recent years,many researches show that the abnormal coagulation system plays an important role in the pathogenesis and development of diabetic angiopathies. Because the coagulation system index is unsystematic and incomplete, its conclusion is still unclear. Through the comparison of 2 diabetes mellitus NPAD with plasma fibrinogen in different levels as well as other risk factors and with the ABI as the diagnostic index of PAD, this paper aims to illustrate the effects plasma fibrinogen changes will bring about onto the forming and development of PAD and the correlation of ABI and plasma fibrinogen, providing the clinic treatment with theretical basis and direction.We selected 63 diabetics who came to the endocrinology branch of our hospital from March 2006 to March 2008, and then ABI were examined in these 63 patients. According to the results, the patients were divided into two groups, including group DPN and group NDPN. Among the 23 persons of DPN group, there are 13 males and 10 females whose mean age is 62.57±9.52 and course of disease is 9.52±5.05,years while among the 40 persons of the NPAD group, there are 25 males and 15 females whose mean age is53.25±10.02 years and course of disease is 5.24±2.32 years. In the group there are 29 cases,of which 22 males and 7 females.What's more,the all have the same case like age (63.47±9.05) years, the course (8.74±4.52).In the control group there are 51 cases,of which 30 males and 21 females, age (48.79±9.84 years), course (5.52±4.75) years. All patients in the rest are measured stature, weight and blood pressure. And then the pulse pressure and BMI are calculated. A biochemical testing was made after 8-12 hours' fasting to measure fibrinogen (FIB), prothrombin time (PT), activated partial thromboplastin time (APTT). In addition, measure fasting blood glucose levels (FBG ), 2 hours postprandial hyperglycemia (PBG2h), total cholesterol (TC), triglycerides (TG), high-density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C) at the same time for blood. All the statistical analysis were dealt with SPSS 12 software. All measurement data was delivered through means value standard errand(x±s).We analyzed the two groups through t test, linear correlation analysis. The case of P<0.05 have statistical meaning.We get the following results: (1) A comparison of fibrinogen between the PAD group and NPAD group: the fibrinogen of severe PAD group is significantly higher than that of the NPAD group (P<0.01) while the fibrinogen of the mild and moderate PAD group is higher than that of NPAD group (P<0.05). Meanwhile, the fibrinogen of the severe PAD group is higher than that of mild and moderate PAD group (P<0.05). The comparisons have statistical meaning. (2) A simple correlation analysis between ABI and FIB of the PAD group and the NPAD group: the results of correlation analysis of PAD group show that the ABI and FIB is significantly negatively correlated (P <0.01), the results of correlation analysis of NPAD group show that the ABI and FIB is significantly negatively correlated (P <0.05), (3) Through comparing the data of PAD group and NPAD group, the differences of BMI and diastolic blood pressure (DBP) have no statistical meaning because P>0.05, on the contrasty, the differences in age, duration, systolic blood pressure (SBP)and pulse pressure have statistical meaning(P<0.05). (4) Through the biochemical data of PAD group and NPAD group: The differences in TC, HDL-C PT and APTT have not statistical meaning while FBG and PBG21h,LDL-C, TG have statistical meaning (P<0.05).We obtain the conclusion that plasma fibrinogen is an important risk factor for PAD, which is closely related to the severity of PA. (2) ABI and FIB is significantly negatively correlated. (3) The ABI should be one of the important clinical testing indicators in the future,which correlates with the risk factors of cardiovascular disease.
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