Study On The Influencing Factors Of Coagulation Function And Distribution Of TCM Syndrome Types In Patients With Chronic Kidney Disease Stage 3-5 Without Dialysi

Objective:to study the changes in coagulation function,influencing factors,and distribution of TCM Syndrome Types in non-dialysis patients with chronic kidney disease in stages 3-5.To study the correlation between hypercoagulable state and baseline,clinical indexes,and TCM syndrome types of patients with chronic kidney disease in stages 3-5.Methods:according to the inclusion and exclusion criteria,non-dialysis patients with CKD in stages 3-5 hospitalized in the Affiliated Hospital of Liaoning University of Traditional Chinese Medicine from December 2020 to December 2021 were collected.The study is divided into two parts:1.Compare the general information,changes in coagulation function,and distribution of TCM syndrome types of patients with different stages of CKD;2.According to the level of plasma fibrinogen,patients with CKD in stages 3-5 were divided into the hypercoagulable group and the non-hypercoagulable group.The general information,laboratory test indexes,and TCM syndrome types distribution of the two groups were compared.The above statistically significant indexes and fibrinogen were analyzed by correlation analysis and binary logistic regression analysis.Results:a total of 132 non-dialysis patients with CKD in stages 3-5 patients were collected,including 73 males（55.3%）and 59 females（44.7%）.The oldest was 85 years old and the youngest was 30 years old.The average age was（60.83±10.21）years old.1.Changes in coagulation function in patients with CKD:There was no significant difference in sex,age,smoking history,history of coronary heart disease,history of diabetes,history of hypertension,and the constituent ratio of primary kidney disease among patients with CKD in stages 3-5（P>0.05）.The levels of PT decreased gradually with the decrease of e GFR,and the levels of APTT,TT,FIB,and D-D increased gradually with the decrease of e GFR.There was no significant difference in the plasma contents of PT,APTT,and TT among CKD groups（P>0.05）;There were significant differences in FIB and D-D levels among CKD groups（P<0.05）;Compared with CKD stage 3,there were significant differences in FIB in CKD stage 4 and CKD stage 5（P<0.01）,and there were significant differences in D-D in CKD stage 5（P<0.01）.2.Comparative analysis of hypercoagulable group and non-hypercoagulable group:there was significant differences between the hypercoagulable group and non-hypercoagulable group in the history of diabetes and coronary heart disease（P<0.05）;There was no significant difference in BUN,UA,TC,LDL between the two groups（P>0.05）;The levels of e GFR,ALB,Ca²⁺and Hb in the hypercoagulable group were lower than those in the non-hypercoagulable group（P<0.05）;Scr,TG,PLT,CRP,NLR and D-D in the hypercoagulable group were significantly higher than those in the non-hypercoagulable group（P<0.05）.3.Distribution of TCM syndrome types:in each stage of CKD,this syndrome presents a similar law,spleen,and kidney qi deficiency syndrome>spleen and kidney yang deficiency syndrome>Yin and yang deficiency syndrome>Qi and yin deficiency syndrome>liver and kidney yin deficiency syndrome.In the standard syndrome,the number of blood stasis syndrome in each stage was the largest,or there was only blood stasis syndrome,dampness turbidity blood stasis syndrome,or dampness heat blood stasis syndrome,the rest followed by dampness turbidity syndrome,dampness heat syndrome,and heat toxin syndrome were less.There was no significant difference between this syndrome and standard syndrome（P>0.05）;In this syndrome,the hypercoagulable group:spleen and kidney qi deficiency syndrome>spleen and kidney yang deficiency syndrome>Yin and yang deficiency syndrome>Qi and yin deficiency syndrome>liver and kidney yin deficiency syndrome;Non-hypercoagulable group:spleen and kidney qi deficiency syndrome>spleen and kidney yang deficiency syndrome>Yin and yang deficiency syndrome>Qi and yin deficiency syndrome>liver and kidney yin deficiency syndrome.Hypercoagulable group in standard syndrome:dampness turbidity and blood stasis syndrome>Blood Stasis Syndrome>dampness turbidity syndrome>dampness heat syndrome>dampness heat and blood stasis syndrome>heat toxin syndrome;Non-hypercoagulable group:dampness turbidity syndrom>dampness heat syndrome>dampness turbidity blood stasis syndrome>Blood Stasis Syndrome>dampness heat blood stasis syndrome=heat toxin syndrome.There were significant differences between the two groups in spleen and kidney qi deficiency syndrome,dampness turbidity,and blood stasis syndrome（P<0.05）,and there was no significant difference between the two groups in other syndromes（P>0.05）.4.Analysis of influencing factors of the hypercoagulable state of CKD:The levels of serum FIB in patients with CKD in stages 3-5 were significantly correlated with history of coronary heart disease,history of diabetes,and the levels of Scr,e GFR,ALB,TG,Ca²⁺,Hb,PLT,CRP,NLR,and D-D（P<0.05）.The serum FIB level of patients with CKD in stages 3-5 was negatively correlated with e GFR,ALB,Hb,and Ca²⁺levels（R<0）,and positively correlated with history of coronary heart disease,history of diabetes,the levels of Scr,TG,PLT,CRP,NLR,and D-D（R<0）.Binary logistic regression analysis showed that triglycerides may be a risk factor for the hypercoagulable state of chronic kidney disease.Conclusion:1.There is a hypercoagulable state in non-dialysis patients with CKD in stages 3-5,which gradually worsen with the decrease of e GFR.2.History of diabetes,history of coronary heart disease,Scr,e GFR,ALB,TG,Ca²⁺,Hb,PLT,CRP,NLR,and D-D were correlated with the hypercoagulable state.3.Hypercoagulable state mainly affects the spleen and kidney qi deficiency syndrome and dampness turbidity and blood stasis syndrome.Pathological factors such as dampness,heat,and blood stasis exist in the form of mutual interaction.4.Triglycerides may be a risk factor for for the hypercoagulable state of chronic kidney disease.