Diagnostic value of ankle-brachial index and toe-brachial index in arterial disease of lower extremity

Objective 　To investigate the clinical application and its influencing factors of ankle-brachial index (ABI) and toe-brachial index (TBI) in the diagnosis of arterial disease of lower extremity. Methods 　ABI and TBI were measured in 800 limbs of 402 patients with diabetes and/or hypertension hospitalized from July 2010 to February 2011. The patients were divided into narrow group (ABI < 0.9), normal group (0.9≤ABI < 1.3), and calcification group (ABI≥1.3) according to the value of ABI, and also into narrow group (TBI < 0.7) and normal group (TBI≥0.7) according to the value of TBI. The correlation of ABI with TBI was analyzed, and the differences in age, obesity parameters, biochemical indicators and other factors were compared between the groups. Influence of high-sensitivity C-reactive protein (hs-CRP) on ABI and TBI was further analyzed. Results 　Only when ABI < 0.9, ABI and TBI have significant correlation (r=0.826, P < 0.01). W hen the group comparison based on ABI values, it was shown that the age and hs-CRP were significantly higher in the narrow group than in the normal group and calcification group (P < 0.01). The comparison between groups based on TBI values indicated that the age, systolic blood pressure and hs-CRP in the narrow group were significantly higher than those in the normal group (P < 0.01 or P < 0.05). ABI and TBI in the normal hs-CRP group were significantly higher than those in high hs-CRP group (P < 0.05). Conclusion 　Hs-CRP may play an important role in the development and progression in peripheral arterial atherosclerosis. Therefore, ABI and TBI measurements in combination with hs-CRP level can improve early diagnosis of arterial disease of lower extremity.