Clinical Characteristics And Prognostic Value Of Yin Deficiency Syndrome In Patients With Chronic Heart Failure At Different Ages

PurposeThe purpose of the article is to study the clinical data of CHF patients with yin deficiency and investigate the influence of factors such as sex,age,echocardiographic index,laboratory index,comorbidity,and integrative syndrome on the 2-year mortality rate of CHF patients,and analyze the influence of age on 2-year mortality on patients with Yin deficiency.MethodA retrospective survey was conducted to collect clinical data of 492 CHF inpatients from the Department of Cardiology at Guang'anmen Hospital of China Academy of Traditional Chinese Medicine from January 2006 to July 2014.Clinical characteristics and laboratory examination data were collected to build a database to process and analyze data.The measurement data that accords with the normal distribution adopts the T-test,the measurement data that does not meet the normal distribution adopts the non-parametric test,the two-factor analysis uses the single-factor correlation analysis;the grouping standard for the ROC curve calculation is plotted,and the Kaplan-Meier survival curve is used to explore The long-term survival value of patients with chronic heart failure was divided into groups.Log-Rank was used to test the differences.Spearman correlation analysis was used to explore the factors associated with the age group of patients with CHF yin deficiency syndrome.Results1.The effect of yin deficiency and heart function grading on the 2-year all-cause mortality of CHF patients was statistically significant(P<0.05 and KM curve did not cross).2.In patients with CHF,cardiac function III and IV are the main factors,and yin deficiency syndrome patients have the highest proportion of grade IV cardiac function;non-yin deficiency syndrome patients have the highest proportion of cardiac function III patients;with heart function With the increase of grading,the number of patients with yin deficiency syndrome also showed an upward trend;the difference between groups had extremely significant statistical significance(P<0.01).The differences of LVEDD,RV,LA,RA,LVEF and FS in age group between patients with CHF yin deficiency syndrome were statistically significant.Among them,LVEDD,RV,LA,RA were significantly negatively correlated with age group,and other indicators were grouped with age.There was a positive correlation.Differences in LVEDD,RV,RA,LVEF,FS and interventricular septum thickness between non-yin and yin deficiency patients were statistically significant between age groups.Among them,LVEDD,RV,and RA were significantly negatively correlated with age group.Positive correlation with age group;differences between groups have significant statistical significance(P<0.05).3.The difference of CA-125 level between the yin deficiency and non-yin deficiency in CHF patients has significant statistical significance(P<0.05),and the level of CA-125 is higher in patients with yin deficiency syndrome.The difference in serum alanine aminotransferase and CA-125 between patients with CHF yin deficiency syndrome was statistically significant(P<0.05),and all of them were significantly negatively correlated with age group;total bilirubin was not found in patients with non-yin deficiency syndrome.The differences between direct bilirubin and indirect bilirubin in the age group were statistically significant,and all were significantly negatively correlated with the age group.4.Factors associated with blood-related indicators in patients with CHF yin deficiency syndrome and age were WBC,RBC,HGB,CRP.Patients with non-yin-deficiency syndrome had RBC and HGB.The difference between groups was statistically significant.P<0.05).Among them,the RBC and HGB of patients with yin deficiency and non-yin-deficiency syndrome decreased with increasing age,and the mean RBC and HGB were lower in the young-aged group with yin-deficiency syndrome,and the RBC,non-yin-deficiency patients in the old age group had RBC,The mean HGB was lower;the WBC and CRP of yin deficiency patients increased with age.5.The difference of the partial pressure of carbon dioxide in CHF patients with renal function index was statistically significant(P<0.05),and it was higher in the younger age group.The difference between Na and UA in patients with CHF yin deficiency syndrome was statistically significant(P<0.05).Among them,UA was significantly negatively correlated with age group,and Na was positively correlated with age group;The difference in fasting blood glucose between age groups was statistically significant,and both were significantly negatively correlated with age grouping.6.The factors associated with yin deficiency in CHF patients with comorbidities and combined syndromes were qi deficiency,yang deficiency,qi stagnation,and blood deficiency.The difference between the two groups was statistically significant(P<0.05).In the yin deficiency syndrome group,there are more yang deficiency,qi stagnation,and blood deficiency in the non-yin deficiency syndrome group.There were coronary heart disease,diabetes mellitus and water drinking in CHF patients with yin deficiency syndrome comorbidities and integrin syndromes related to age group,and coronary heart disease,hypertension,and hyperlipidemia in patients with non-yin deficiency syndrome.Significant statistical significance(P<0.05).Among them,yin deficiency syndrome with coronary heart disease,diabetes in the elderly group more,the merger of water drinkers in the elderly group is less;but for non-yin deficiency patients,with coronary heart disease,hypertension,hyperlipidemia in the elderly More in the group.7.Analysis of the 492 patients included in the study by ROC curve found that age was significant for the 2-year survival rate of CHF patients(P<0.05);when the age was 75.5 years,it was the best cut-off value.8.The Kaplan-Meier survival curve was used to analyze the effect of age on the 2-year mortality of patients with yin deficiency syndrome.It was found that the 2-year mortality rate of yin-deficiency patients aged 75 years and below was significantly higher than that of non-yin deficiency groups(P<0.05).For patients over 75 years of age,whether yin deficiency has no significant effect on their 2-year mortality.ConclusionThrough clinical research,we found that CHF yin deficiency pathogenesis is more common in patients with moderate to severe disease,and relatively young patients are more critical and have a poor prognosis.Yin deficiency is common in the elderly,but the use of diuretics in CHF in modern medical treatment often causes blood The reduction in volume appears to be due to treatment-induced yin deficiency,and we have shown that yin deficiency patients have a higher 2-year mortality rate compared to the younger group,and therefore diuresis should be used in CHF patients,especially younger patients.