The Related Research Of ANCA-Associated Vasculitis Renal Damage Of Blood Stasis Syndrome And Serum HMGB1

Objective:1.To explore the possible role of serum high mobility group box protein B1(HMGB1)in the pathogenesis of ANCA-associated vasculitis(AASV)renal impairment.2.To distribute different TCM syndromes of AASV renal damage,count the blood stasis in the proportion of all the collected cases.3.To investigate the possible role of serum HMGB1 in AASV renal damage of blood stasis,which can provide clues for AASV renal damage in TCM in the part of diagnosis and treatment.Methods:Selected patients with AASV renal damage in XXX Hospital Depatment Of Nephrology 42 cases from July 2015 to November 2016,then observe the distribution of blood stasis syndrome in all syndromes after the initial visit of TCM syndrome differentiation.According to the syndrome types,the patients with AASV renal impairment after the differentiation of TCM were divided into blood stasis group and non blood stasis group,and 30 healthy persons with the same age and sex were selected as control group.Serum HMGB1 levels were measured by enzyme-linked immunosorbent assay(ELISA),and the levels of HMGB1 and CRP,urea nitrogen(BUN),D-dimer,albumin,Hb,24h urine,protein quantitative,creatinine(Scr)and some other factors were analyzed by each other.Results:1.The level of serum HMGB1 in the control group was significantly lower than that in the blood stasis group and the non-blood stasis group(P<0.05).Serum HMGB1 levels were correlated with CRP,D-dimer,ANCA titer and BVAS scores in patients with AASV renal impairment(P<0.05),and compared with BUN,Scr,GFR,white Protein,24h urinary protein,Hb and renal damage were not correlated(P>0.05).According to the presence of after hemodialysis were divided into two groups,to compare the difference between whether hemodialysis patients serum HMGB1 level,and the difference were statistically significant(P<0.05),the results suggest that non-hemodialysis serum HMGB1 values lower than hemodialysis group.2.The distribution of TCM syndromes of AASV kidney injury:deficiency of both spleen and kidney(SKD)was 18 cases(42.85%),qi-yin deficiency(QYD)was 13 cases(30.95%),pulmonosplenic qi(PSQA)5 cases(11.90%),endoretention of damp heat(EDH)was 6 cases(14.29%),of which there were 24 cases(57.14%)of stasis syndrome.3.The levels of HMGB1,D-dimer,CRP,ANCA and BVAS in blood stasis group were significantly higher than those in non-blood stasis group(P<0.05).There was no significant difference between the two groups in the levels of BUN,GFR,Scr,Hb,albumin,24h urinary protein.(P>0.05).Conclusion:1.Serum HMGB1 was involved in the pathogenesis of AASV renal damage and was positively correlated with DUN,CPR,BVAS and ANCA titer,and correlated with BUN,Scr,GFR,albumin,24h urinary protein,Hb,renal damage And so there is no obvious linear correlation.2.AASV renal damage of TCM syndrome types is deficiency of spleen and kidney deficiency syndrome and qi and yin deficiency syndrome,the proportion of the two groups accounted for 73.8%,the proportion of blood stasis is 57.14%.3.Serum HMGB1 was significantly increased in blood stasis syndrome of AASV renal damage,which suggests that serum HMGB1 may be involved in the pathogenesis of blood stasis syndrome.