Hcy Levels And TCM Syndrome Characteristics In Diabetic Nephropathy Patients With CAS

Objective:There are many patients with diabetic Kidney Disease(DKD)complicated with carotid artery sclerosis(CAS),and the occurrence of CAS can be used as a "window" to monitor cardiovascular diseases.In recent years,homocysteine(Hcy)has attracted much attention as a new cardiovascular risk factor,and kidney is one of the organs of Hcy metabolism.In this study,the influence of Hey level on carotid intima media thickness(CIMT)in patients with DKD and CAS was studied,so as to further study the relationship between Hey level and cardiovascular diseases in patients with DKD and CAS.The distribution characteristics of TCM syndromes in patients with DKD and CAS were analyzed,so as to facilitate TCM clinical syndrome differentiation and treatment,and prevent and delay the occurrence and development of cardiovascular diseases.Method:According to the research content,relevant case report form(CRF)was developed,clinical data of 198 patients with DKD were collected,and the obtained data were analyzed.According to the diagnostic criteria of DKD and DKD with CAS,the included patients were divided into simple DKD group(80 cases)and DKD with CAS group(118 cases).The general condition and Hcy level of patients with DKD and CAS were compared and analyzed,and the clinical characteristics of patients with DKD and CAS were observed.The distribution characteristics of TCM syndromes in patients with DKD and CAS were analyzed.Result:1.DKD patients with CAS were older,had longer course of disease,had higher proportion of smokers and had higher systolic blood pressure,and the differences were statistically significant(P<0.05)compared with the DKD group alone.2.LDL-C,24h-UPR,Scr and BUN in DKD patients with CAS were higher than those in DKD patients alone,and EGFR was lower than those in DKD patients alone,the difference was statistically significant(P<0.05).3.The level of CIMT in DKD patients with CAS was significantly higher than that in DKD alone group(P<0.05),and CIMT was positively correlated with LDL-C,Hcy,24h-UPR,BUN and Scr(P<0.05).Was negatively correlated with EGFR(r=-0.420,P=0.000).4.The level of Hcy in patients with DKD has certain diagnostic significance for the occurrence of CAS.5.Hcy was positively correlated with 24h-UPR,BUN and Scr in DKD patients(P<0.05).Was negatively correlated with EGFR(r=-0.407,P=0.000).6.1n DKD patients with CAS,Yin deficiency syndrome accounted for more than the original deficiency syndrome.Standard evidence in the damp heat syndrome accounted for more;The comparison of Hcy level in different TCM syndromes of DKD with CAS showed that the Hcy level in group B was higher than that in the syndrome of Yang deficiency and blood stasis.Moreover,the elevated Hey level in DKD patients with CAS may be a risk factor for blood stasis syndrome.Conclusion:1.Patients with DKD with CAS were characterized by increased LDL-C Hcy 24H-Upr BUN Scr level and decreased eGFR.2.1n this study,the level of Hey in DKD with CAS group was significantly higher,and Hcy was positively correlated with 24h-UPR,BUN and Scr,while negatively correlated with EGFR.3.In DKD patients with CAS,Yin deficiency syndrome was more common.Standard evidence with damp heat syndrome accounted for more;...