Analysis Of TCM Syndrome Changes And Influencing Factors In Patients With Stage 3-5 Chronic Kidney Disease Complicated With Abdominal Aortic Calcification Without Dialysis

Objective: By collecting Chinese medicine hospital in hubei province chronic kidney disease(chornic kidney diseases,chronic kidney disease(CKD))3-5)combined Abdominal aortic calcification in dialysis patients clinical data,related analysis period Abdominal aortic calcification in patients with chronic kidney disease(CKD)(Abdominal aortic calcification,AAC)occurrence and influencing factors,and discuss the age,neutrophil count/lymphocyte count ratio(neutrophil-to-lymphocyte thewire,Clinical evaluation of AAC by NLR and other indicators provides a basis for vascular calcification in patients with advanced CKD as well as for TCM syndrome differentiation and treatment.Methods: selected from June 2018 to December 2019 in the department of nephrology,hubei hospital of traditional Chinese medicine117 non-dialysis patients of ckd3-5 were followed up,and general data of the patients were collected,including gender,age,height,body mass,body mass index(BMI),blood pressure,pulse pressure difference,history of primary disease,hypertension or diabetes,medication status,and TCM syndromes.Laboratory examination included serum creatinine(Scr),albumin,urea nitrogen,estimated glomerular filtration rate,fasting blood glucose,neutrophil count,lymphocyte count,blood calcium,blood phosphorus,high sensitive c-reactive protein(hs-crp),riglyceride(TG),and total cholesterol.TC),high density lipoprotein cholesterol(hdl-c),low density lipoprotein cholesterol(ldl-c),parathyroid hormone(PTH),etc.Abdominal aortic calcification was examined by lateral abdominal radiographs,and the prevalence of AAC and its related influencing factors were analyzed and evaluated.Results: 1.A total of 117 ckd3-5 non-dialysis patients were enrolled,including 71 males with an average age of(60.9±10.9)years and an average course of disease of(127.6±114.2)months,and 46 females with an average age of(61.3±10.1)years and an average course of disease of(121.1±110.4)months.The incidence rate of abdominal aortic calcification was 41.9%(49 cases),and the average age of the calcification group was 66.1±7.7 years,which was significantly higher than that of the non-calcification group(57.5±10.8 years)(P < 0.01).Patients with calcification combination,hypertension and smoking were higher than those without calcification(P < 0.05).There was no significant difference between the two groups in gender,BMI and diabetes mellitus(P > 0.05).2.In terms of TCM syndrome types,among the 117 patients,the spleen-kidney qi deficiency syndrome was the most common(41%),followed by spleen-kidney Yang deficiency syndrome(25%)and yin-yang deficiency syndrome(20%),and yin-yang deficiency syndrome(14%).In the standard empirical study,the maximum number of patients with wet turbidity syndrome was 45(38%),followed by 43(37%)patients with blood stasis syndrome,and at least 29(37%)patients with damp and heat syndrome.In the calcification group,qi and Yin deficiency syndrome accounted for the highest proportion(36.7%),followed by spleen-kidney Yang deficiency syndrome(24.5%)and yin-yang deficiency syndrome(20.4%),and spleen-kidney qi deficiency syndrome(18.4%).In the non-calcification group,spleen and kidney qi deficiency syndrome was the first,accounting for 57.4%,followed by spleen and kidney Yang deficiency syndrome,accounting for 25%,qi and Yin deficiency syndrome and Yin and Yang deficiency syndrome accounted for 8.8%.In the positive evidence of calcification group,the blood stasis,wet turbidity and damp and heat syndrome account for 51.0%,28.6% and20.4% respectively.In the non-calcified group,the maximum was 45.6%,followed by 27.9%,followed by 26.5%.3.NLR level,ldl-c,pulse pressure difference and hs-crp in the calcification group were all higher than those in the non-calcification group(P < 0.05).CKD3-5 phase correlation analysis in dialysis patients with abdominal aortic calcification with age(r = 0.411,P < 0.001),hypertension(r = 0.235,P = 0.011),smoking(r = 0.208,P = 0.024),pulse pressure difference(r = 0.194,P = 0.034),NLR(r = 0.371,P < 0.001),the Hs CRP(r = 0.185,P = 0.046),LDL-C(r = 0.222,P = 0.016),PTH(r =0.348,P < 0.001)were positively correlated.4.Binary logistic regression analysis showed that age(P = 0.002),NLR(P = 0.021)and ldl-c(P = 0.038)were independent risk factors for abdominal aortic calcification.With the increase of age,NLR and ldl-c levels,the risk of abdominal aortic calcification in ckd3-5 non-dialysis patients increased.5.The area under the ROC curve showed that the maximum area under the age was 0.741(P < 0.001),followed by 0.717(P < 0.001)of the NLR,and the smallest area was ldl-c0.630(P < 0.05).The results showed that the predictive value of age,NLR and ldl-c for AAC decreased successively.Conclusion:1.Non-dialysis patients with ckd3-5 have a high risk of abdominal aortic calcification,hypertension and aspiration Smoke,PTH,ldl-c and hs-crp were correlated with the occurrence of abdominal aortic calcification.2.In the non-dialysis patients with stage ckd3-5 complicated with abdominal aortic calcification,qi and Yin were the two deficiency syndromes The proportion of blood stasis was the highest in standard evidence.In patients without calcification,spleen-kidney qi deficiency syndrome accounted for the highest proportion,and dampness syndrome was more common.3.Age,NLR and ldl-c are independent risk factors for abdominal aortic calcification.It is valuable to predict the occurrence of abdominal aortic calcification.