A Comparative Analysis Of Elderly Patients With Hypertension Of Early Renal Damage In Different Syndrome Types

Objectives:Analyze the elderly hypertensive patients from the community with different syndromes of renal damage between urine kidney injury 5 and serum cystatin C differences to provide evidences for the TCM syndromes differentiation and early diagnosis of hypertensive renal damage.Methods:According to the medical records of prospective survey methods, we collected the general conditions (including name, gender, age, blood pressure, medical history, course of disease, symptoms, etc.) of the resident who live in Jingzhuang Town area in Yanqing County. The blood pressure was measured three times within one week but not one day, if the patient met the inclusion criteria and not in exclusion criteria. Then we did 24-hour ABPM for the patients who met the standards for high blood pressure. If the results of 24-hour ABPM met the inclusion criteria, the patient was enrolled. According to the relevant standards,122 patients that had been selected were divided into 3 groups: phlegm and blood obstruction, yin deficiency with yang hyperactivity and kidney deficiency. There were 39 cases in phlegm and blood obstruction group,21 males and 18 females; 44 patients in yin deficiency group,18 males and 26 females; 39 patients in kidney deficiency group,19 males and 20 females. Blood and urine samples were sent to the Laboratory Medicine of Xiyuan Hospital testing of urine kidney injury 5 (MALB, TRF, NAG,β2-MG, IgG) and serum Cyst-c. We compare each syndrome group indicators of early renal damage (urine kidney injury 5 and serum Cyst-c) and analyze the statistical data.Results:There is no significant difference in number of Elderly patients with essential hypertension in phlegm and blood obstruction group, yin deficiency with yang hyperactivity group and kidney deficiency group. There are significant differences (P<0.01) between kidney deficiency and phlegm and blood obstruction group, kidney deficiency and yin deficiency with yang hyperactivity group, but no significant difference (P>0.05) between phlegm and blood obstruction and yin deficiency with yang hyperactivity group in MALB, TRF andβ2-MG. There is no significant difference (P>0.05) in comparison of NAG among the three groups. There is significant difference (P<0.05) between kidney deficiency and phlegm and blood obstruction group in the comparison of IgG, no significant difference (P>0.05) is showed in the comparison of other groups. Serum Cyst-c in the three syndromes compared between two groups is significantly different (P<0.01). Conclusions:It is balance in phlegm and blood obstruction group, yin deficiency with yang hyperactivity group and kidney deficiency group in the elderly patients with essential hypertension. MALB, TRF andβ2-MG in the Kidney deficiency group are significantly higher than in the other two groups. IgG in the Kidney deficiency group is significantly higher than in the phlegm and blood obstruction group. There is no significant difference among the three groups in NAG. There are significant differences between the three syndromes in Serum Cyst-c, and phlegm and blood obstruction< yin deficiency with yang hyperactivity< Kidney deficiency group. Overall, the early renal damage in the group of Kidney deficiency is serious than the other two groups in the elderly hypertensive patients. Serum Cyst-c combined urine kidney injury 5 (MALB, TRF, NAG,β2-MG, IgG) is more sensitive in early diagnosis of hypertensive renal damage.