| Objective:To research the factors which influence ABI, the correlation amongABI, the classification of TCM, and clinical symptoms. To research the clinicalsignificance and the standard value of ABI to diagnose LEADDP early bycomparison of Color Doppler Ultrasound, so that we can find a simpler andcheaper method to diagnose LEADDP early.Method:We chose 90 cases that corresponded with diagnostic criteria for DMmade by WHO in 1999. All patients came from the department of endocrinologyof Guangzhou Hospital of TCM. We recorded all patients' relational data suchas age, gender, hight, weight, BMI, blood pressure, pulse of dorsal artery offoot, the course of the disease, FBG, 2hPBG, HbA1C, TC, TG, HDL-C, LDL-C, and soon. All patients underwent ABI and CDU. We gave every patient proper scoresabout clinical symptoms including claudication, pain, anaesthesia and senseof heaviness. We divided them into five groups according to TCM syndromedifferentiation. The five groups were the syndrome of heat due to deficiencyof yin group, syndrome of dampness-heat disturbing spleen group, syndrome ofdeficiency of both qi and yin group, syndrome of deficiency of both yin andyang group and syndrome of blood stasis blocking collaterals. Data wereanalyzed by SPSS 10.0 version statistic software. All the continuous variableswere presented as mean±SEM. We used one-way ANOVA test and a Student t testto estimate relationships of the enumeration data. Chisquare analysis wasemployed to estimate the measurement data, and did relational analysis.Results: 90 cases included 52 males and 38 females. The age ranged from 55to 90. The mean age was 68.43±10.11. The course of the DM disease rangedfrom 5 years to 32 years. The mean course of the DM disease was 11.3±6.85years. The mean ABI was 0.925±0.284 and 0.898±0.268 for left and right. There was no significant diference between left and right ABI. T test: p=0.408.Pearson correlation showed there was negative correlation between ABI and age,PBG, HbA1c, SBP, DBP, LDL-C. There was no correlation between ABI and the courseof the DM disease, BMI, FBG, TG, HDL-C, TC. There was significant diferenceof both ABI between the group with coronary heart disease and the group withoutcoronary heart disease, p＜0.05(p=0.021, p=0.017). The group with coronaryheart had a lower ABI. There was no significant diference of both ABI betweenthe group with cerebrovascular disease, diabetic retinopathy, diabeticnephropathy and the group without these diseases, p＞0.05. As the differentgrades Of the scores of clinical symptoms, there was significant diferenceof both ABI between the group with severe symptoms and the group with slightsymptoms. According to the result of Color Doppler Ultrasound, 156 of 180 lowerextremity arteries had sclerosis with different extent. 98 of 180 lowerextremity arteries were judged by CDU as LEADDP. The sensitivity, specifity,the positive predictive value, the negative predictive value and accuracy ofABI≤0.8 were 52.04％, 98.78％, 98.08％, 63.28％, 73.33％. The sensitivity,specifity, the positive predictive value, the negative predictive value andaccuracy of ABI≤0.9 were 77.55％, 96.34％, 96.2％, 78.22％, 86.11％.Thesensitivity, specifity, the positive predictive value, the negative predictivevalue and accuracy of ABI≤1.0 were 86.73％, 75.61％, 82.95％, 82.67％, 81.67％。ABI≤0.9 was the most accute. The left and right ABI of the syndrome ofdeficiency of both yin and yang group was lowest. There was statistic diferenceof left ABI between the syndrome of deficiency of both yin and yang group andthe syndrome of heat due to deficiency of yin group, syndrome of dampness-heatdisturbing spleen group. There was statistic diference of right ABI betweenthe syndrome of deficiency of both yin and yang group and the syndrome ofdampness-heat disturbing spleen group.Conclusions: ABI was influented by age, PBG, HbA1c, SBP, DBP and LDL-C. Thegroup with coronary heart disease had a lower ABI. ABI was on the decline withthe more severe symptom. In some Diabetes Patients with lower extremityarterial disease, ABI had been abnormal before symptoms occurred. The leftand right ABI of the syndrome of deficiency of both yin and yang group waslowest. By contrast with Color Doppler Ultrasound, the accuracy of ABI≤0.9was highest. As a result, we can record ABI≤0.9 as a a simpler and cheapermethod to diagnose LEADDP early.
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