| Background and ObjectiveDiabetes prevalence rate was high, and the harm was huge, its complications, as a serious world’s medical problem, had been caused severe damage to human’s health. The prevalence of type2diabetes was as high as9.7%in our country, had become the third disease among patients behind cardiovascular disease and tumor. Peripheral Artery Disease (PAD) was a serious chronic diabetic complication. It might cause occlusion limb gangrene, even life-threatening serious amputation disability because of vascular stenosis. Therefore, the prevention and early diagnosis and treatment of diabetic lower extremity artery occlusion caused the attention of home and abroad scholars. Ankle-brachial index (ABI) was screening method of sensitivity and specificity for lower limb arterial ischemic lesions. ABI screening methods for Type2Diabetes Mellitus (T2DM) had been used. In a cross-sectional study, it was important to make sure disease prevalence rate and degree of lower limb artery occlusion and clinical features of diabetic foot in order to provide scientific basis for early diagnosis and treatment. Analysis of related factors of diabetic lower extremity peripheral arterial disease had provided theoretical basis for preventing artery lesions. Methods1. From January2007to December2011,4286cases of T2DM were selected from Henan Provincial People’s Hospital. Unified survey was conducted and recorded one by one by trained endocrinologists. General circumstances include gender, age, duration of diabetes, family history, smoking history, obesity, sedentary, high fat food, dyslipidemia, high blood pressure. Clinical manifestations of complications of diabetic lower extremity macrovascular are as follows:numbness, weakness, pain, cold sensation, skin discoloration, intermittent claudication, foot ulcers and necrosis.2. Adopt Versalab SE instrument, ABI examination was conducted by trained technical personnel.3. The criteria of judging ABI:Normal0.9≤ABI<1.3; Abnormal0.9> ABI<0.9, or ABI≥1.3. The level of ABI abnormity:mildly abnormal ABI0.6≤ABI<0.9; moderately abnormal,0.3≤ABI<0.6; severely abnormal<0.3.4. Analyzing the correlation between ABI and current symptoms, and apply Logistic regression analysis to investigate the risk factors influencing the ABI. Abnormity of ABI (ABI<0.9) as the dependent variable, gender, age, course of the disease, smoking, family history, sedentary, obesity, high fat diet, high cholesterol, high blood pressure as the independent variable in multivariate logistic regression analysis.5. At the same time, relevant examination and Wagner classification of patients was conducted to observe the effects of different treatments on the disease outcome.6Treatment:(1) Control blood sugar, and diabetic foot and comprehensive treatment,(2) percutaneous transluminal angiography (PTA) therapy (3) Surgery.Results1. Among4286cases of ABI screening of diabetic patients, ABI abnormity rate was11.7%(n=501), mildly abnormal, moderately abnormal and severely abnormal were344cases (68.6%),90cases (18.0%) and30cases (6.0%) respectively. In addition, ABI≥1.3for37cases (7.4%)。2. Relevant factors caused ABI abnormal:age, blood fat metabolic disorder, hypertension, smoking, sedentary, course of diseases. 3. Cases of ABI abnormities with diabetic foot patients accounted for30.1%(n=151).4. ABI was severely abnormal for the vast majority of patients with diabetic foot, and most patients accompanied Diabetic Peripheral Neuropathy (DPN) at the same time. The main cause of diabetic foot including diabetes artery pathological changed and DPN.5. Forms of diabetic foot:ischemia, ulcers, gangrene, and co-infection.6. Follow-up:the curative effect observation of151cases of diabetic foot after treatment. Comprehensive treatment, signs and symptoms turned better (101cases,67%). Digit necrosis off after treatment, the wound healed (9cases,6%). PTA improved the blood supply to the lower limbs (35cases,23%). Amputation (6cases,4%).Conclusions1. ABI was an effective method to screen PAD, the abnormity rate of ABI higher than ten percent for T2DM patients. ABI screening could find lower limb artery blood supply obstacles in early stage, making patients take treatment in time to decrease the rate of diabetic foot amputation, optimistic clinical therapeutic effect was obtained.2. Age, dyslipidemia, hypertension, smoking, sedentary, course of DM diseases were all the relevant causes of ABI abnormity. It is useful to shift the lifestyle of patients, and it has provided important evidence prevention and treatment of diabetic foot. |
PDF Full Text Request