Research On The Correlation Between Pulse Pressure And NLR,Serum Bilirubin And Serum Uric Acid In Hypertensive Patients With Different TCM Syndromes

Objective: Through analyze the relationship between pulse pressure(PP)and neutrophil /lymphocyte ratio(NLR),serum bilirubin,serum uric acid(UA)in patients with hypertension of different chinese medicine(CM)syndrome,to provide basis for syndrome differentiation of hypertension and reference for prevention and treatment of cardio-cerebrovascular diseases.Methods: A total of 573 patients with hypertention were selected from June 2014 to December2019 in Department of Cardiology,Department of hypertensive Sleep Disorders and Department of Neurology of the affiliated Hospital of Gansu University of traditional Chinese Medicine.Collected the general data,clinical symptoms,blood routine,biochemical examination results,24-hour ambulatory blood pressure and calculated the ratio of neutrophils to lymphocytes.The selected patients were divided into deficiency of kidney qi,hyperactivity of liver fire,mutual knot of phlegm and blood stasis,deficiency yin and hyperactivity yang According to the syndrome diagnostic criteria in the implementation plan of traditional Chinese Medicine Pathway for vertigo(essential hypertension).Apply SPSS 21.0 statistical software analyze the relationship between pulse pressure and NLR,serum bilirubin,serum uric acid in patients of different CM syndrome types.Results:1 In 573 patients with hypertension,deficiency yin and hyperactivity yang syndrome 217 case,accounting for 38.87%,mutual knot of phlegm and blood stasis syndrome 186 cases,accounting for 32.46%,deficiency of kidney qi syndrome 108 cases,accounting for18.85%,hyperactivity of liver fire syndrome 62 cases,accounting for 10.82%.2 There were significant differences in 24hMPP(H=30.834,P=0.000),NLR(H=11.276,P=0.010),TBIL(H=9.730,P=0.021),IBIL(H=11.545,P=0.009)and UA(H=16.739,P=0.001)among different CM syndromes.Compared with the two groups,24 h MPP in hyperactivity of liver fire was significantly lower than deficiency of kidney qi,mutual knot of phlegm and blood stasis,yin deficiency and yang hyperactivity(P < 0.05).The NLR in mutual knot of phlegm and blood stasis exceeds than hyperactivity of liver fire(P < 0.05).TBIL was significantly higher in hyperactivity of liver fire than in deficiency of kidney qi(P< 0.05).IBIL was significantly higher in hyperactivity of liver fire than in deficiency ofkidney qi and mutual knot of phlegm and blood stasis(P<0.05).The UA in mutual knot of phlegm and blood stasis highger than deficiency yin and hyperactivity yang,deficiency of kidney qi and higher in hyperactivity of liver(P < 0.05).3 573 patients with hypertension,there were significant differences in NLR(H=21.633,P=0.000),TBIL(H=8.888,P=0.012),IBIL(H=10.556,P=0.005),UA(H=10.421,P=0.005)among differentpulse pressure levels.NLR and UA were the lowest at < 45 mmhg level,and > 53 mmhg was the highest;TBIL and IBIL were the highest at < 45 mmhg level,and > 53 mmhg was the lowest.4 24 hMPP was positively correlated with NLR(rs=0.197,P=0.000),negatively correlated with TBIL(rs=-0.128,P=0.002)and IBIL(rs=-0.138,P=0.001),and positively correlated with UA(rs=0.119,P=0.004).5 The 24 hMPP was positively correlated with NLR of kidney qi deficiency syndrome(rs=0.205,P=0.037)and of mutual knot of phlegm and blood stasis(rs=0.247,P=0.001)and of deficiency yin and hyperactivity yang(rs=0.177,P=0.009).the 24 hMPP positively correlated UA of mutual knot of phlegm and blood stasis(rs=0.219,P=0.003).The 24 hMPP was negatively correlated with TBIL(rs=-0.203,P=0.003)and IBIL(rs=-0.191,P=0.005)and negatively correlated with DBIL(rs=-0.141,P=0.038)of deficiency yin and hyperactivity yang.Conclusion: 1.24 hMPP,NLR,TBIL,IBIL,UA in different types of TCM hypertension patients have a certain degree of change rule,which can provide a certain objective basis for hypertension syndrome differentiation.2.In patients with hypertension,NLR and UA increased with the increase of 24 hMPP,while TBIL and IBIL decreased with the increase of 24 hMPP.3.The NLR of hypertensive patients with kidney qi deficiency syndrome,phlegm-blood stasis syndrome and yin deficiency and yang hyperactivity syndrome increased with the 24hMPP;UA increased with the increase of 24 hMPP in mutual knot of phlegm and blood stasis syndrome group;TBIL,IBIL and DBIL decreased with the increase of 24 hMPP in deficiency yin and hyperactivity yang syndrome group.