الفهرس 
COVEROnly 14 pages are availabe for public view
 |  | from | 195 |  |  |
| | | from | 195 | | |
Abstract
Peripheral arterial disease is a slow and progressive circulatory disorder outside of brain and heart. PAD results when a disruption in the blood flow, transport of nutrients and oxygen and elimination of waste products in the circulatory system occurs.
The risk factors associated with PAD are similar to those for ischemic heart disease. There are reversible risk factors ( smoking, hyperlipidemia, hypertension, diabetes and obesity) and irreversible risk factors ( age, gender, and family history).
PAD patients are classified into (Asymptomatic PAD, Intermittent claudication which is classified according to Rutherford-Baker classification from R-B I to R-B VI, Chronic limb ischemia and Acute limb ischemia)
Complications of PAD include; Thrombosis, Embolism, Recurrent infection, Gangrene, Amputation, Skin ulceration and renal insufficiency.
PAD diagnosis includes, Awareness of PAD, Physical examination, Non invasive procedure as ABI- Doppler ultra sound-CT-MRI, Invasive procedure and Laboratory diagnosis.
Laboratory diagnosis includes detection of markers in blood. These markers include: markers of inflammation as (CRP, WBC, IL-6, cellular adhesion molecules and ß2 microglobulin), markers of thrombosis as (D-dimer, fibrinogen), Lipoprotein-a, vit.C, and Homocystiene.
This study was conducted on 28 patients presented with PAD, and 20 age and sex matched healthy individuals were included as a control group.
Patients were subdivided into 3 classes ( class I, class II, class III) according to R-B classification of severity
hs-CRP and D-dimer were detected by ELISA technique. Fibrinogen was detected by clotting rate assay method.
In our study we found that patients had a significantly higher levels of hs CRP and D-dimer comparing to healthy controls but there was no significant difference observed as regards fibrinogen level. Also on comparing patients´ subgroups (class I,II,III) healthy controls we found that there were significantly higher levels of hs CRP and D-dimer but there was no significant difference according to fibrinogen level except in (class I).
Further analysis of patients´ subgroups as regards presence of pathological states revealed a borderline significant association of progressive disease ( i.e class III) with presence of anemia ( P 0.07) and high levels of hs CRP (P 0.06).
Multiple regression analysis of the 3 measured parameters together (P= 1.2) did not provide a significantly higher capacity than each parameter alone (P= 0.000 for Ddimer , P= 0.17 for fibrinogen , and P=0.5 for CRP ) for the diagnosis of PAD.
Multiple regression analysis of D-dimer and fibrinogen together provided a significantly higher capacity (P=0.000) than either test alone (P= 0.000 for D-dimer and P=0.17 for fibrinogen ) for diagnosis of PAD.