The Clinical Screening Strategy Analysis Of Peripheral Artery Atherosclerosis In Type 2 Diabetic Inpatients

The prevalence of Diabetes mellitus(DM) in our country was 11.6%, The pre-diaebetes was as much as 15.5%.Vascular lesions are serious complications of DM patients,it is also the main cause of death,60% ~ 80% DM patients died of blood vessel related diseases.Peripheral arterial disease( PAD) is a part of the vascular lesions,it has the characteristics of high prevalence, high morbidity and high mortality, at the same time, it has the low diagnostic rate, low treatment and low awareness characteristics.Therefore, early screening for PAD is very important. It is generally believed that screening for carotid artery lesions can be used as a systemic of atherosclerosis(AS) in ordinary people.DM merger lower limb artery lesions has a wide scope of lesions, symmetry, diffuse characteristics,whether simple screening for carotid ultrasound can fully represent the degree of pathological changes of lower limb artery,and how to early screening for PAD,This study will be to discuss the above questions.A total of 332 patients with type 2 diabetes in department of endocrinology,Air Force General Hospital from Jan 2015 to Oct 2015 were recruited.They had made carotid artery or lower limb artery Color Doppler Ultrasound(CDU) inspection,and the general clinical data and complications of patients were recorded. According to the result of the CDU is divided into no lesion group and disease group,and calculate the prevalence of AS. And according to the results of the different parts of CDU detection is divided into carotid lesions subgroups and lower limb artery lesions subgroups, respectively comparative analysis with the group of corresponding without pathological changes,then summed up the risk factor for AS.The relationship between the incidence of arterial AS and related factors was analyzed by Logistic regressive model. Using kappa consistency check the screening prevalence of carotid atherosclerosis and lower limb artery ultrasound.This research results included: 1. Parallel diagnosis calculation of total prevalence of AS was 87.27%, carotid atherosclerosis(CAS) prevalence was 72.0%, the incidence of lower extremity atherosclerosis(LEAS) was 79.6%, the both lesions prevalence is 62.55%. 2. In 275 patients,carotid artery lesions characterized by 217 cases has artery intima-medial thickening, 198 cases has artery plaque formation,34 cases has artery stenosis, 10 cases has artery occlusion; The lower extremity artery lesions characterized by 215 cases artery intima-medial thickening, 219 cases artery plaque formation, 98 cases artery stenosis, 41 cases artery occlusion. 3. Compared with N-AS group, AS group has older age, longer duration of DM; higher level of FIB, CAIMT measured value higher(P<0.01). Complications(hypertension, coronary heart disease, cerebral infarction) and diabetes complications(DPN, DN, DR, DF) prevalence is higher(P<0.05).TG levels, ABI, TBI measured values are lower(P<0.05). 4.Carotid artery and lower extremity artery atherosclerotic lesions are as the growth of the age and the prevalence increased with the extension of duration of diabetes. 5.Carotid artery and lower extremity artery atheromatous plaque characteristics are mainly multiple plaques, 56.7% and 66.2% respectively. 6. The consistency check of Carotid and lower limb artery ultrasound screening for atherosclerosis kappa = 0.345. 7. Logistc analysis shows that duration of DM>10 years, age>60 years old, higher SBP, concurrent DPN are independent risk factors for carotid atherosclerosis;Duration of DM>10 years, age>60 years old. Men, merge with the DN are independent risk factors for lower extremity.The conclusion in the present study: 1. Using two parallel diagnostic test screening of diabetes atherosclerosis was obviously higher than that of pure with any a way of screening. 2. With the same individual of DM patients, different arterial atherosclerotic lesionsite has different characteristics. 3. Carotid artery and lower extremity artery atherosclerotic lesions are as the growth of the age and the prevalence increased with the extension of duration of diabetes. 4. Carotid artery can’t completely reaction lower extremity lesions, the carotid artery and lower extremity artery CDU check cannot replace each other. 5.AS associated with a variety of risk factors,for diabetes course of 10 years or more, the age of 60 or more patients, whether clinical symptoms,it need to take AS into consideration.Systolic blood pressure higher, the merger of DPN, should focus on screening cervical artery. Older men, merge the DN to key screening lower limb artery atherosclerotic lesions.