Research On Climate Features And Prognostic Value Of Clinical Chronic Heart Failure Patients PBSS

Objectives:To explore the long-term prognosis of chronic heart failure(CHF) patients with phlegm block or blood stasis. And to invest the influencing factors of TCM syndrome.Methods:We collected276cases of CHF patients who were hospitalized in Guang’ anmen Hospital, China Academy of Chinese Medical Sciences from January2006to December2012. Then gathered their general information, incidence, the results of laboratory and function tests, relevant medical history, and TCM syndrome. All the patients were outpatient or telephone followed-up, to obtain their final events. Then used Survival-Analysis Method to explore the long-term prognosis of CHF patients with phlegm block or blood stasis, and searched the impacts of objective index on the syndrome differentiation.Results:The median follow-up time of785(1110) days, all cause mortality was32.8%at the end of the follow-up. In276cases, the phlegm block had151cases, the blood stasis had175cases, the phlegm and blood stasis had84cases. Kaplan-Meier-Survival-Analysis showed that the phlegm block patients than the blood stasis ones have better long-term prognosis, and the phlegm and blood stasis patients were in between. The correlation analysis showed that, relevant factors of phlegm block were:NYHA-FC (R=-0.123, P=0.041)、NT-proBNP (R=-0.131, P=0.042)、TG (R=0.125, P=0.045), relevant factors of blood stasis were:Age (R=-0.120, P=0.046)、Hyperlipidemia (R=0.168, P=0.005)、RV (R=0.126, P=0.039)、 Pulmonary regurgitation (R=0.129, P=0.035), relevant factors of phlegm and blood stasis were:Gender (R=0.203, P=0.027)、Age (R=-0.276, P=0.002)、LVEF(R=-0.195, P=0.040)、 Hyperlipidemia(R=0.190, P=0.039)、UA(R=0.186, P=0.045)、LVEDD(R=0.194, P=0.040)、 RV(R=0.206, P=0.029)、 RA(R=0.200, P=0.034). The Logistic Regression Analysis showed that, the relevant factors entered into phlegm block equation were:PLT (B=-0.006, P=0.008, Exp(B)=0.994), the relevant factors entered into blood stasis equation were:Hyperlipidemia (B=0.657, P=0.040, Exp(B)=1.929)、 RBC(B=1.166, P=0.044, Exp(B)=3.208), the relevant factors entered into phlegm and blood stasis equation were:Age (B=-0.139, P=0.005, Exp(B)=0.870)、 LVEF (B=-8.748, P=0.024, Exp(B)=0.000)、 Hypertension (B=1.528, P=0.038, Exp(B)=4.608). With non-phlegm block and non-blood stasis as the reference category, the relevant factors entered into phlegm block equation were:LVEDD (B=0.072, P=0.039, Exp(B)=1.075), the relevant factors entered into blood stasis equation were:RBC (B=2.222, P=0.019, Exp(B)=9.229)、LVEDD (B=0.065, P=0.038, Exp(B)=1.067)Conclusions:The phlegm block patients than the blood stasis ones have better long-term prognosis, and the phlegm and blood stasis patients were in between. Phlegm syndrome often occurs in the early stage of CHF, and blood stasis syndrome is common in patients with severe-late-stage.The main influencing factors of phlegm syndrome are NYHA-FC、 NT-proBNP、TG、PLT etc, the main influencing factors of blood stasis syndrome are Age、 RBC、Lipid levels、Heart cavity diameter etc, the main influencing factors of phlegm and blood stasis are Gender、Age、LVEF、Lipid levels、UA、Heart cavity diameter etc. But our study did not considerthe interaction between these factors, so whether it can be used to guide the clinical syndrome differentiation, remains to be further studied.