Clinical Application Of Ankle Brachial Index And Pulse Wave Velocity In Hypertension With Type 2 Diabetes Mellitus

Objective:Hypertension and diabetes is the world's climactic chronic diseases,and the arteriosclerosis plays an important role in the onset of these diseases.Considering the importance of arteriosclerosis and reduce the incidence of cardiovascular disease,as non-invasive indexes of assessing the degree of artery obstruct and artery stiffness,the Ankle brachial index and Pulse wave velocity are causing the clinical attention day by day too.This study was to explore the value of Ankle brachial index and Pulse wave velocity in Hypertension with Type 2 diabetes mellitus,to know the artery sclerosis in patients with hypertension and diabetes,and to analysis the roles of Ankle brachial index and Pulse wave velocity and their relation in these disease.Methods:Sixty essential hypertension patients(33 cases of male,27 cases of female),60 type 2 diabetes patients(29 cases of male,31 cases of female),120 hypertension combined with type 2 diabetes patients(50 cases of male,70 cases of female),45 normal adults(20 cases of female,25 cases of female)in Affiliated Hospital of Chengde Medical College from May 2015 to March2016 were selected and studied.they are separated into four groups,clinical date were collected,each group measured Ankle brachial index?Pulse wave velocity?blood pressure?blood glucose?C-reactive protein index and so on,group of diabetes and group of hypertension ang diabetes still need glycosylated hemoglobin test.The dates were anaiyzed by analysis of variance,to analyze the influence factors of Ankle brachial index and Pulse wave velocity by multiple stepwise,Diagnostic criteria based on hypertension prevention and control of hypertension guidelines to China in 2010.Type 2diabetes diagnostic criteria of diabetes mellitus and according to the 2013 China standards.All selected objects to examine the informed consent.Results:1 Between group of hypertension?diabetes?hypertension and diabetes?health,there were no ststistically significant difference in general clinical date of age?sex?body mass index,etc(P>0.05);Compared with control group,the C-reactive protein ? systolic blood pressure ? diastolic blood pressure were statistically significant in group of hypertension(P<0.05);Compared with control group,the fasting blood glucos?glycosylated hemoglobin?creatinine?C-reactive protein were statistically significant in group of diabetes(P<0.05);Compared with group of hypertension?diabetes,the fasting blood glucos?C-reactive protein ? systolic blood pressure ? diastolic blood pressure were statistically significant in group of hypertension and diabetes(P<0.05).2 Group of hypertension?diabetes?hypertension and diabetes?health with Ankle brachial index respectively(1.15±0.07)?(1.07±0.92)?(1.03±0.08)?(1.18±0.79),it is concluded that Ankle brachial index value in group of diabetes and group of hypertension and diabetes were obviously lower than control group,the difference was statistically significant(P<0.05);Ankle brachial index value in group of hypertension and diabetes was lower than that in the other groups,the difference was statistically significant(P<0.05);Ankle brachial index value in group of hypertension was not statistically significant than control group(P>0.05);Group of hypertension?diabetes?hypertension and diabetes?health with Pulse wave velocity respectively(1740±202)cm/s?(1432±106)cm/s?(1986±348)cm/s?(1372±117)cm/s,it is concluded that Pulse wave velocity value in group of hypertension and group of hypertension and diabetes were obviously lower than control group,the difference was statistically significant(P<0.05);Pulse wave velocity value in group of hypertension and diabetes was obviously higher than that in the other groups,the difference was statistically significant(P<0.05);Pulse wave velocity value in group of diabetes was not statistically significant than control group(P>0.05).3 By Logistic regression analysis,Ankle brachial index is related to fasting blood glucose(OR=2.38,95% CI 1.03 ~ 2.21)?2-hour postprandial blood glucose(OR=1.95,95%CI 1.62~2.26)? C-reactive protein(OR=2.12,95% CI 1.24 ~ 2.36);Pulse wave velocity is related to age(OR=2.25,95% CI1.23 ~ 2.38)?systolic blood pressure(OR=2.16,95% CI 1.54 ~ 3.08)?diastolic blood pressure(OR=1.98,95% CI 1.46 ~ 2.95)?C-reactive protein(OR=2.34,95%CI 1.89 ~ 1.97).4 Linear regression analysis showed that Pulse wave velocity and Ankle brachial index has a better linear relationship,the regression equation for PWV(cm/s)= 972.33 + 228.76 ABI.Conclusions:1 Ankle brachial index and Pulse wave velocity as the detection index of artery arteriosclerosis,the method is simple?effective?repetitive,and can predict the risk of cardiovascular disease,maenwhile hypertension and diabetes togetherly accelerate the development of arteriosclerosis,promote the damage of vascular structure and function.2 Ankle brachial index affected by fasting blood glucose ? 2-hour postprandial blood glucose ? c-reactive protein,has nothing to do with the blood fat?glycosylated hemoglobin;Pulse wave velocity is closely related to age?systolic pressure?diastolic blood pressure?c-reactive protein,and has no impact on blood fat.3 The change of the Pulse wave velocity is affected by the Ankle brachial index,both were positively correlated.