Application Opportunity Of CT Angiography Combined With Doppler Ultrasound And Ankle Brachial Index In Diabetic Lower Extremity Arterial Disease

Objective: To provide reference for early clinical diagnosis and intervention measures of lower extremity arterial disease(LEAD)of diabetes,the opportunity of doppler ultrasound(DUS)and ankle brachial index(ABI)combined with CT angiography(CTA)was discussed through the examination of DUS,ABI and CTA in patients with lower extremity arterial disease of diabetes in different Fontaine stages.At the same time,to explore the risk factors that aggravate lower extremity arterial disease in diabetes,the related indicators that affect the progression of lower extremity arterial disease in diabetes were analyzed.Methods: 106 patients with LEAD of type 2 diabetes who had undergone ABI,lower extremity artery DUS and lower extremity artery CTA examinations were included.According to the clinical symptoms,106 patients were divided into four stages on the basis of Fontaine stage.The clinical data of each patient was collected.The results of DUS,ABI and CTA in patients with LEAD of type2 diabetes in different Fontaine stages were compared,and the risk factors such as age,gender,diabetes course,smoking history,hyperlipidemia,hypertension,coronary heart disease,cerebrovascular disease were analyzed.The counting data was expressed in the number of cases or percentages,and the measuring data was expressed in mean ± SD.Pairing χ2 was used to compare the difference between CTA and DUS,CTA and ABI respectively.Ordinal logistic regression analysis was used to analyze the risk factors of LEAD in diabetes.P < 0.05 was statistically significant.Results:1.Comparison of DUS and CTA in patients with different Fontaine stages1.1 The positive detection results of CTA and DUS in patients with Fontaine I and II were different(P < 0.05).In Fontaine III and IV patients,there was no significant difference between CTA and DUS in the positive detection results of LEAD in diabetes(P > 0.05).1.2 The diseased vessels were divided into two subgroups: mild to moderate stenosis and severe stenosis or occlusion based on the results of CTA.Both subgroups were compared with the results of DUS.The results showed that the vessels CTA showed mild to moderate stenosis and the positive rate of stenosis on DUS was 17.95 %;the vessels CTA showed severe stenosis or occlusion and the positive rate of stenosis on DUS was 89.9 %.2.Comparison of ABI and CTA in patients with different Fontaine stages2.1 There was significant difference(P < 0.05)between the detection results of CTA and ABI in patients with different Fontaine stages.The consistency of the detection of LEAD in diabetes by the two inspection methods was low.2.2 The patients with vascular stenosis displayed on CTA were divided into two subgroups-superior genicular artery and inferior genicular arterybased on the results of CTA,and they were compared with ABI respectively.The results showed that ABI was more sensitive to superior genicular artery stenosis than inferior genicular artery stenosis in all Fontaine Ⅰ-Ⅳ patients.In Fontaine I and II patients,the consistency of CTA and ABI in detecting the stenosis of the inferior genicular artery was low,but with the aggravation of the clinical symptoms of patients,the consistency of CTA and ABI in detecting the stenosis of the inferior genicular artery was gradually increasing in Fontaine III and IV patients.3.Logistic regression analysis showed that hypertension was an independent risk factor affecting the progression of LEAD in diabetes.Conclusions:1.For patients with LEAD of diabetes in Fontaine stage I and II,even if DUS shows no obvious vascular stenosis,or ABI > 0.9,early combined with CTA examination can find lower extremity arterial disease of diabetes earlier,which can reduce missed diagnosis and achieve the goal of early prevention and early treatment.2.Diabetes patients with LEAD should strictly control blood pressure to delay the progress of the disease.