| ObjectivePrimary nephrotic syndrome(PNS)is one of the most common kidney diseases in the Nephrology department.Adult PNS not only reduces the quality of life of patients,but also increases the financial burden on patients and their families.The relapse of PNS is the difficulty and focus of treatment,how to improve the long-term remission rate of PNS has become the key to the treatment of PNS.This paper discusses the risk factors of adult PNS relapse and frequency relapses,as well as the analysis of TCM syndromes,and provides a clinical predictive method for clinical treatment and prognosis diagnosis.Methods1.From the first affiliated Hospital of Guangzhou University of Traditional Chinese medicine,adults diagnosed with PNS from January 2012 to June 2018 were the subject of study to collect clinical data and laboratory test results from the initial illness.2.A total of 136 cases were collected,of which 45 cases were not recurrence group,56 cases of non-frequent recurrence group and 35 cases of frequency recurrence group.Collect 24 variables,including sex,age,sickness,TCM syndromes,medication regimen,and whether there is a basic disease at the time of medical treatment.The counting data using x 2 test,metering data using T test for single factor analysis,to the difference of statistically significant variables to draw ROC graph,according to the clinical reality and the index to determine the cut-off value of the study variables,the statistically significant variables for multi-factor logistic regression analysis,The independent risk factors related to PNS relapse and frequent relapse were screened.Results1.In the single variable analysis of risk factors for the relapse of adult PNS,it was found that there were statistically significant differences between the two groups in the presence of basic diseases at the time of medical treatment,the complications associated with PNS at the time of medical treatment,the dialectical division of TCM,the quantification of 24-hour urinary protein,serum albumin,cholesterol and low density lipoprotein.Further regression analysis can be obtained:24 hours urine protein quantitative?7.26g(OR:2.809,95%ci:1.156-6.828 P=0.023),total cholesterol?11.26mmol/l(OR:2.586,95%ci:1.022-6.543;P=0.045),the presence of basic diseases(OR:5.420,95%CI:1.946-15.093;P=0.001)and the presence of NS related complications(OR:4.786,95%ci:1.821-12.575;P=0.001)at the time of the visit is an adult PNS An independent risk factor for relapse.In patients with TCM syndrome differentiation as Qi(yang)deficiency,the chance of recurrence was 3.605 times times that of patients with wet and hot syndrome(OR:3.605,95%ci:1.045-12.437;P=0.0042).2.In the single-variable analysis of the risk factors of PNS frequent relapses in adults,it is found that there are basic diseases at the time of medical treatment,complications related to PNS,TCM syndrome differentiation,plasma globulin,low density lipoprotein,and differences between the two groups.Further regression analysis concluded that there were NS related complications(OR:2.942,95%ci:1.141-7.586;P=)in low density lipoprotein?7.46mmol/l(OR:2.586,95%ci:1.597-12.746;p=0.004)and at the time of medical treatment.0.0026)is an independent risk factor for the adult PNS frequent recurrences.Plasma globulin?22.6g(OR:0.21,95%ci:0.070-0.628 P=0.005)is a protective factor in PNS patients.In patients with syndrome differentiation as Qi(yang)deficiency,the probability of relapse was 4.171 times times higher than that of patients with wet and hot syndrome(OR:4.171,95%ci:1.022-17.026;P=0.0042).ConclusionThe existence of basic disease or NS related complications and TCM syndrome differentiation as gas(yang)deficiency is a risk factor for the relapse of adult PNS and frequent relapses.An independent risk factor for the relapse of adult PNS:24 hours urine protein quantitative?7.26g,cholesterol ?11.26mmol/l.An independent risk factor for PNS frequent relapses in adults:low density lipoprotein?7.46mmol/L.Plasma globulin?22.6g is a protective factor for the PNS frequent relapses... |
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