| Objective:By studying the middle molecular toxin in the serum of patients with chronic renal insufficiency accumulation and its related indicators of cardiovascular disease, investigate the effect of middle molecular toxin on the cardiovascular system. In addition, the application of traditional proprietary Chinese medicines Uremic Clearance Granule to assess the effect of its removal of middle molecular toxins (intact iPTH, serum cystatin C, AGEs), and to observe the role of the prevention and treatment of cardiovascular disease.Method:Eligible for inclusion criteria for the diagnosis of stage CKD2and CKD3patients, randomly divided into Niaoduqing group of42cases and the control group of38cases. The treatment of two groups are high-quality low-protein diet based on protein quantification in a day0.6-0.8g/kg (no more than40g/day), a-keto acid tablets (4tablets/time,3times/day) and to maintain sufficient heat supply. Hypertension and electrolyte imbalance were given symptomatic treatment. The Niaoduqing group on the basic treatment plus Uremic Clearance Granule4times a day (6h,12h,18h, each serving a bag,22h clothing bags). Eight weeks as a course. Observe the two groups before treatment and eight weeks after treatment of serum creatinine (Scr), blood urea nitrogen (BUN), uric acid (UA), albumin, hemoglobin concentration (Hb), Ca2+,P3--level, myocardial enzymes, brain natriuretic peptide, echocardiography examination and iPTH, serum cystatin C, AGEs and other indicators to improve the situation.Results:1, Niaoduqing group creatinine from the (207.88±53.29) umol/l droped to (184.76±52.65) umol/l, urea nitrogen from the (14.84±7.20) mmol/l to (11.81±4.46) mmol/l, uric acid from the (515.6±105.11) umol/l to (469.38±97.63) umol/l, after treatment, the level of creatinine, urea and uric acid decreased, the difference was statistically significant (p<0.05); the control group of creatinine from (198.05±76.09) umol/1droped to (192.74±73.03) umol/l, urea nitrogen from (14.79±9.09) mmol/l to (13.94±9.21) mmol/l, uric acid from (514.53±173.26) umol/1to (474.37±194.96) umol/1, the level of uric acid, urea, creatinine compared before and after treatment has declined, but the difference was significant (p>0.05); Niaoduqing group compared with the control group after treatment no significant difference (p>0.05).2,Niaoduqing group in hemoglobin concentration from (107.93±20.30) g/L increased to (118.24±19.83) g/L, albumin from (35.00±6.41) g/L increased to (38.95±7.14)g/L, the average of hemoglobin concentration, albumin after treatment significantly higher than those before, the difference was statistically significant (P<0.05); hemoglobin concentration of the control group from (108.84±27.56)g/L increased to (117.11±28.50)g/L albumin from (34.97±71)g/L increased to (38.87±11.98) g/L, before and after treatment contrast was increased, but the difference was significant (p>0.05) after treatment Niaoduqing group compared with the control group had no significant difference (p>0.05).3, Cystatin C of Niaoduqing group in (2.92±1.70)mg/l decreased to (2.33±1.49)mg/l, IPTH from the (99.64±89.86)pg/ml to (62.56±56.53)pg/ml, there was significant difference between before and after treatment (p<0.05), AGEs fron the (435.87±105.23) ng/l decreased to (372.01±86.58)g/l, there was significant difference between before and after treatment(p<0.01); the control group cystatin C from the (2.91±1.51)mg/l decreased to (2.71±1.32)mg/l, iPTH from (100.41±63.09)pg/ml to (88.63±55.77)pg/ml, AGEs from (435.77±82.88)g/l decreased to (427.73±92.49) ng/l, the level has declined after treatment, but the difference was significant (p>0.05); the (?)TH period of intact parathyroid hormone after treatment in the control group had difference significant (p<0.05), AGEs after treatment compared with the same period in the control group with significant difference (p<0.01).4, Niaoduqing group of lactate dehydrogenase from the (187.48±83.52)U/L, droped to (163.71±65.83)U/L, alpha-hydroxybutyrate dehydrogenase from the (146.74±59.25) U/L to (126.88±47.31)U/L. the level were significantly lower, the difference was statistically significant (p<0.01); lactate dehydrogenase in the control group after treatment from the (187.68±86.77) U/L decreased to (167.32±52.68) U/L, alpha-hydroxybutyrate dehydrogenase from the (147.74±62.49) U/L decreased to (139.26±44.03) U/L, lower than before treatment, but the difference was significant (p>0.05); alpha hydroxybutyrate dehydrogenase after treatment with the same period in the control group there was significant difference (p<0.05).5,①Cystatin C and septum, brain natriuretic peptide was positively correlated (r=0.352, Pbilatcrally=0.032, r=0.304, Pbilateral=0.006), and left atrial diameter was negatively correlated (r=-0.476, P bilateral=0.009);②iPTH and brain natriuretic peptide was positively correlated (r=0.439, Pbilaterally=0.000);③AGEs and brain natriuretic peptide, left ventricular internal diameter, end-diastolic capacity was positively correlated (r=0.400,Pbilaterally=0.000, r=0.349Pbilaterally=0.034, r=0.337, Pbilateral=0.042).Conclusion:1, Uremic Clearance granule combined with modern medical conventional therapy in the treatment of chronic renal insufficiency contributes to remove small molecules and middle molecular in the body of toxins.2, Middle molecular toxins and cardiovascular indicators have some correlations. Middle molecular toxins may have a certain impact on the development of cardiovascular disease.3, Uremic Clearance granule help clear molecules toxins in the body. We presume it could improve cardiovascular indexs... |
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