| Objective：The aim of the present study was to learn about adjusting the ankle-brachial index (ABI)screening range (the new screening criteria) impact on the detection rate and its significance and toinvestigate the relationship between ABI values and the related factors in diabetic patients withlower-extremity arterial disease.Methods：Using diabetic foot diagnosis case as an effective equivalent by the ankle-brachial bloodpressure ratio and doppler waveform et al to assess the diabetic patients with lower limb blood flow and toobtain ankle-brachial index ABI values. According to the measurement results,divided the ABI values intothe normal group (1.0≤ABI≤1.3) and abnormal group (ABI <1.0or ABI>1.3).Try to compare the newscreening criteria and old one:ABI normal group (0.9≤ABI≤1.4), ABI abnormal group (ABI <0.9orABI>1.4),which the differences of two different partition methods.And to compare the ABI values amongthe three groups with the general clinical data, complications, the biochemical indexes of existence, so asto explore the relationship among factors and ABI.Results：A total of203cases of type2diabetic patients with normal ABI group is102cases, ABI <1.0group is77cases,ABI>1.3group is24cases, ABI abnormal rate is49.75%.1.There was statistically significant difference between two different ABI classification method(χ~2=242.373, P<0.001),and the new criteria(ABI<1.0and ABI>1.3) was more easily detected theabnormal.Meanwhile,new screening criteria in the authenticity of the results of the evaluation of abnormaldetection rate we had came to: the new ABI criteria for the classification of the specificity was77.3%, asensitivity was100.0%, positive likelihood ratio was4.4, and negative likelihood ratio was0,Youdenindex was0.773.2. There was statistically significant difference in age, gender, duration of diabetes, waist-to-hip ratio, bodymass index, systolic pressure (P<0.05).3.In the history of smoking and diastolic pressure there was no significant statistical difference (P>0.05).4.In the fasting c-peptide, lipoprotein a, fibrinogen, D-two dimers, C reactive protein, urinary albumin,urinary24h protein, urea nitrogen, the percentage of neutrophils, homocysteine, insulin use (years),therewere significant differences between the normal ABI group and ABI<1.0group,(P<0.05);in ABI>1.3group,the fasting C peptide, low density lipoprotein, D-two dimer, urinary albumin, neutrophil percentage,insulin use (years) had a significant differences with the normal ABI group (P<0.05); the fibrinogen, Creactive protein, glycosylated hemoglobin had a significant differences compare with the ABI<1.0group(P<0.05).5.Each group in the fasting insulin, triglyceride, total cholesterol, fasting blood glucose, postprandial bloodglucose, uric acid, white blood cell count index had no significant differences (P>0.05).6.Multivariate logistic regression analysis showed that waist-to-hip ratio, fasting C-peptide, age, genderand duration of diabetes, fasting insulin, C-reactive protein, glycosylated hemoglobin into the regressionequation, were the major risk factors of ABI<1.0group;waist-hip ratio, fasting C-peptide, age and duration of diabetes which were the independent risk factors of ABI>1.3group.Conclusion：1. The ankle brachial index (ABI) is a strong factor for screening diabetic lower extremity arterial disease.The waist-to-hip ratio, fasting C peptide, age, gender and duration of diabetes, fasting insulin, C reactiveprotein, glycated hemoglobin are the major risk factors of ABI<1.0group; In ABI>1.3group, thewaist-to-hip ratio, fasting C-peptide, age and duration of diabetes are the independent risk factors.2. This study suggests that diabetic patients with diabetic lower-extremity arterial disease of ABI<1.0group and diabetic patients with lower extremity arterial calcification of ABI>1.3group as a screeningcut-off point may be more conducive to the diabetic lower extremity vascular lesions of patients with earlyscreening and intervention. |
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