Correlation Between Different Serum Albumin Levels And Heart Failure And Association Rules Of TCM Syndrome

Objective:1.To investigate the relationship between serum albumin level and chronic heart failure;2.To analyze the correlation between TCM syndrome differentiation of chronic heart failure and serum albumin level.As a result,it offers a new index of references for the diagnosis and management of chronic heart failure using Western and Chinese medicine.Methods:Through the electronic information system of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,934patients who met the diagnostic criteria of chronic heart failure and 1059patients without a clear history of heart failure during the same period were selected as the heart failure group,and 1059 patients without a clear history of heart failure during the same period were collected as the control group,and the general clinical data of both groups,such as gender,age,history of hypertension,history of diabetes,history of atrial fibrillation and serological indicators(blood calcium.Serological indices（blood calcium,alanine aminotransferase,aspartate aminotransferase,serum albumin,γ-glutamyl transferase,alkaline phosphatase,uric acid,urea,creatinine,glucose,total cholesterol,triglycerides,lipoprotein B,lipoprotein A1,N-terminal B-type natriuretic peptidogen）were compared.The tests with statistical differences were also substituted into binary logistic regression The risk factors for the development of chronic heart failure were analyzed,and the ROC curve was used to clarify the diagnostic value of albumin for the development of chronic heart failure.The patients in the heart failure group were divided into three groups according to the diagnostic criteria of Chinese medicine.Qi and Yin deficiency type,Qi deficiency and blood stasis type,and heart and kidney Yang deficiency type.The differences in serum albumin and N-terminal B-type natriuretic peptide levels between the three groups were compared.All data were statistically analyzed using IBM SPSS 23.0,and P<0.05 indicated that the differences were statistically significant.Results:1.The study included 934 patients with heart failure,including 522 men and 412 women,with a median age of 70 years;the control group had 1059 cases,including 450 men and 609 women,with a median age of 68 years.The general clinical data of the two groups of patients were compared.The results showed that the difference in age was not statistically significant（P>0.05）and the difference in gender was statistically significant（P<0.05）.Compared with the control group,the levels of serum albumin,serum calcium,total cholesterol,lipoprotein A1,lipoprotein B and triglycerides were lower in the heart failure group,and the differences between the two groups were statistically significant（P<0.05）.The levels of alkaline phosphatase,aspartate aminotransferase,gamma-glutamyl transferase,urea,creatinine,uric acid and glucose were higher and the difference was statistically significant.（P<0.05）.2.Statistical analysis using multivariate logistic regression showed that serum albumin（OR=0.930,P<0.01）was an independent risk factor for the development of chronic heart failure after adjusting for the effects of multiple confounders.3.Correlation analysis of serum albumin with other parameters in heart failure group showed that serum albumin was negatively correlated with alkaline phosphatase,urea,creatinine,triglyceride and pro-B-type natriuretic peptide,and serum albumin was positively correlated with Ca²⁺,alanine aminotransferase,total cholesterol,apolipoprotein A1 and apolipoprotein B（P<0.05）.4.The patients in the heart failure group were divided into three groups according to NYHA class:cardiac function classⅡ,classⅢand classⅣ.The data analysis of serum albumin levels in the three groups showed that the serum albumin levels showed a decreasing trend with the increase of the severity of heart failure,and there were significant differences in serum albumin levels among the three groups（P<0.05）.5.Using ROC statistics,the results showed that the area under ROC curve of serum albumin in the diagnosis of chronic heart failure was 0.651（P<0.01）,and the cutoff value on ROC curve was 34.55 mmol/L,when the sensitivity was 93.58%and the specificity was 40.41%.6.The comparison of serum albumin and B-type natriuretic peptide levels in patients with chronic heart failure of different TCM syndromes showed that the data differences between the three groups were statistically significant（P<0.01）.The serum albumin level was gradually increased according to the order of heart and kidney yang deficiency→qi deficiency and blood stasis→qi and yin deficiency（P<0.01）,and the level of B-type natriuretic peptide was gradually increased according to the order of qi and yin deficiency→qi deficiency and blood stasis→heart and kidney yang deficiency.7.There were significant differences in the distribution of different TCM syndromes of heart failure and NYHA functional classification,and according to the order of deficiency of both qi and yin/qi deficiency and blood stasis→heart-kidney yang deficiency,chronic heart failure showed an aggravating trend（P<0.05）.Conclusion:1.Serum albumin is an independent risk factor for chronic heart failure,and is significantly associated with the severity of chronic heart failure,and has a good predictive effect on the occurrence of chronic heart failure.2.Serum albumin is correlated with TCM syndrome differentiation of chronic heart failure,which has certain reference value for TCM syndrome differentiation and treatment of chronic heart failure in the future.