The Correlation Analysis Between Clinical Indicators Such As BNP And Syndrome Factors Of The Qi Defficiency With Phlegm Blocked And Blood Stasis Syndrome Type In The Patients Diagnosed With AMI

ObjectiveIt is a retrospective study among the patients diagnosed with AMI concerning the relationship between syndrome type of Qi deficiency with phlegm blocked and blood stasis and clinical indicators such as coronary artery lesion, BNP, platelet aggregation rate and blood pressure, blood lipid and blood glucose. We hope it will help evaluate the condition of the patients. What’ s more, we study the relationship between clinical indicators and syndrome type subgroups of Qi deficiency, phlegm blocked and blood stasis of patients to provide fact-based evidence to instruct treatment by syndrome differentiation.MethodThis study collected 142 cases about patients who diagnosed with AMI with Qi deficiency with phlegm blocked and blood stasis syndrome type from February 2013 to February 2015 in cardiovascular department of Guangdong hospitaL_of TCM. We divide the syndrome type into 3 subgroups as follows, Qi deficiency with 31 cases, phlegm blocked with 79 cases and blood stasis with 70 cases by TCM syndrome element differentiation standard of CHD. We record the characteristic of the patients and clinical indicators such as coronary artery lesion, BNP, platelet aggregation rate and blood pressure, and then analysis the difference and correlation between the 3 subgroups.Result1. Among the 142 cases,31(21.8%) are belonged to Qi deficiency subgroup, 79(55.6%) in phlegm block subgroup and 70(49.3%) in blood stasis subgroup.2. The distribution of gender and age show statistical significance between the 3 subgroups(P<0.05). Statistical difference in gender distribution (P =0.016<0.05) is showed between the Qi deficiency group and phlegm block group. Statistically significant difference (P=0.006<0.01) is showed in age distribution. However.no statistical difference (P> 0.05) is found in both gender and age distribution between the blood stasis group and the other groups.3. We make pairwise comparison between the distribution of coronary artery lesion amount from the 3 subgroups which shows no statistical difference (P >0.05).4. We make pairwise comparison between the clinical indicators SBP, DBP and PP from the 3 subgroups which shows no statistical difference (P> 0.05).5. We can see that the BNP level in Qi deficiency group is statistically higher than phlegm block group (P=0.015) and blood stasis group (P=0.041) and has no statistical difference between phlegm block or blood stasis group (P=0.239>0.05).6. Platelet aggregation rate is statistically higher (P=0.037<0.05) in blood stasis group than in Qi deficiency group and no statistical difference between phlegm block group and Qi deficiency group (P=0.322) or blood stasis group (P=0.132).7. We make pairwise comparison of the blood lipid level between the 3 subgroups. The LDL-C level is statistically higher in Qi deficiency group than phlegm block group (P=0.034<0.05) and has no statistical difference between blood stasis group and phlegm block group or Qi deficiency group (P> 0.05). HDL-C level shows no statistical difference (P> 0.05) between the 3 subgroups.TC level is statistically higher (P=0.03<0.05) in phlegm block group than in Qi deficiency group and has no statistical difference between Qi deficiency group and blood stasis group (P=0.322) as well as phlegm block group and blood stasis group.Since the TG level isn’t accord with normal distribution, we compare it among the 3 subgroups by rank-sum test. The result shows the TG level between Qi deficiency group is statistically lower (P=0.037<0.05) than phlegm block group (P=0.049) or blood stasis group (P=0.030) and has no statistical difference between phlegm block group and blood stasis group (P>0.05)8. No statistical difference is found in HbA1 level between the 3 subgroups (P>0.05).9. The correlation analysis between Qi deficiency group and clinical indicators shows that Qi deficiency syndrome type is positively correlated with BNP level (P<0.01), age (P<0.01).gender (P<0.05) and is negatively correlated with LDL-C,TG level (P<0.05).BNP level is an independent factor of Qi deficiency analyzed by logistic regression. The regression equation is logit (P)=-2.427+0.003BNP (pg/ml) (partial regression coefficent P <0.05)10. The correlation analysis shows no significant correlation between phlegm block group and clinical indicators (P>0.05).11.The correlation analysis shows no significant correlation between blood stasis group and clinical indicators (P>0.05). But these is a tendency of positive correlation in platelet aggregation rate and blood stasis syndrome type (P=0.043<0.05). Platelet aggregation rate is an independent factor of blood stasis analyzed by logistic regression. The regression equation is logit (P)= logit (P)=-1.123+0.021Platelet aggregation rate (%) (partial regression coefficent P<0.05).The imitative effect is poor since R2 is small.12. No statistical difference is found in gender distribution between the 3 different coronary artery lesion amount subgroups (P>0.05).while is found the distribution of age show statistical significance difference (P=0.002 <0.01) between single branch lesion group and the other two groups. It also shows no statistical difference between double branch lesion group and the other two groups (P>0.05).No statistical difference is found in each single factor between the 3 different coronary disease subgroups (P>0.05). The three branch lesion group of LDL-C is higher than that of single lesion group, which are differences trend, but show no statistical significance (P= 0.08 > 0.05).Double branch lesion group (P= 0.078) and the three lesion group (P = 0.099) of PP was higher than single lesion group, which are differences trend, but they had no statistical significance (P>0.05).Conclusion1. Among the 142 patients diagnosed as AMI with Qi deficiency, phlegm block and blood stasis. The percentage is significant higher in phlegm block and blood stasis group than Qi deficiency. Patients are older and female percentage are higher in Qi deficiency group than phlemg block group.2. There is no significant difference between coronary artery lesion, blood pressure and HbAl among the 3 subgroups.3. The BNP level is an independent influential factor in Qi deficiency group.4. Platelet aggregation rate is an independent influential factor in blood stasis group.5. Compared with the other group, the level of LDL-C, TC and TG has a tendency of significant difference in phlegm block group, but it doesn’t show statistically difference yet.