Study On The Clinical Diagnostic Methods Of Peripheral Arterial Disease In Type Ⅱ Diabetes

Objective: To evaluate the clinical value of diagnosing peripheral artery disease (PAD) in diabetes with the method of personal vascular laboratory (PVL).Methods: PAD was estimated by color Doppler ultrasound (CDU) and PVL in 80 limbs of forty old male inpatients with type II diabetes mellitus (DM) selected from Department of Geriatric Endocrinology of General Hospital of PLA. Taking CDU diagnostic standard as definition, the related diagnostic criterions of PAD were assessed by the two methods of ankle - brachial index (ABI) and PVL.Results: 90% of the lower limbs under investigation had arteriosclerosis (AS) diagnosed by CDU, among which, 40% had convex plaques and vascular stenosis of more than 50% of vascular diameter. Among the PVL-diagnosed lower limbs which PAD took 35% of the total number, 27.5% were found to have ABI≤ 1.0 and 22.5% with ABI ≤0.9. 32.5% were diagnosed PAD by both CDU and PVL. Using the PAD criterion by CDU, the sensitivity of PVL was 81.25%, the specificity was 95.83%, the positive predictive value was 92. 86%, the negative predictive value was 88.46% and the global accuracy was 90%. The sensitivity of ABI ≤0.9 was 56.25%, the specificity was 100%, the positive predictive value was 100%, the negative predictive value was 77.42% and the global accuracy was 82.5%, while the corresponding values for the use of ABI ≤1.0 were 62.5%, 93.75%, 86.96%, 78.95% and 81.25% respectively. CDU diagnosed PAD limbs had lower ABI values compared to the non-PAD limbs, and the difference was statistically significant.Conclusions: Using CDU as diagnostic standard for PAD, PVL was shown to be an efficient diagnostic method for PAD. The accuracy of PAD diagnosis by systematic PVL analysis was higher than that of ABI alone.