Maintenance Hemodialysis Patients With Blood Stasis And Endothelial Function Correlation Studies

Object:Bleeding tendency and thrombot ic compl ications are the most common causes of death of hemodialysis patients and the difficulties of renal replacement therapy. The treatment contradiction of the mentioned two problems is whether the patients of maintenance hemodialysis are given anticoagulant drugs or their bleeding and thromboembolism will endanger their lives. Therefore, the subject is carried out to study the relevance between the maintenance hemodialysis patients'blood stasis and their endothelial function, aiming at seeking the relevant factors which influence the maintenance hemodialysis patients'hypercoagulability and the best point of penetration of prevention and treatment.Methods:Divide120maintenance hemodialysis patients into blood stasis syndrome group and non-blood stasis syndrome group. At the same time, detect the index of ET, NO, Cr, BUN and CRP.Results:(1) There are80patients (33males and47females) in the blood stasis syndrome group. Their average age is60.09±10.237. Their average hemodialysis time are39.56±25.754months. Among the patients of protopathy,18of them are chronic glomerulonephritis,37of them are diabetic nephropathy,12of them are hypertensive nephropathy,5of them are Aristolochic acid nephropathy,4of them are polycystic kidney,3of them are nephrotic syndrome and one of them is obstructive nephropathy. According to the different types of blood stasis syndrome,37of them are blood stasis caused by qi deficiency,19of them are blood stasis caused by blood deficiency,2of them are blood stasis due to qi stagnation,11of them are blood stasis due to cold congealing,9of them are blood stasis caused by phlegm turbidity and2of them are blood stasis caused by heat toxin. There are40patients (24males and16females) in the non-blood stasis syndrome group. Their average age is59.50±13.162. Their average hemodialysis time are33.42±25.728months. Among the patients of protopathy,14of them are chronic glomerulonephriti s,12of them are diabetic nephropathy,5of them are hypertensive nephropathy,4of them are Aristolochic acid nephropathy and5of them are polycystic kidney.(2) Comparisons between the blood stasis syndrome group and the non-blood stasis syndrome group:when comparing the ET content in blood serum of the two groups, P<0.05; when comparing the NO content in blood serum of the two groups, P<0.01.(3) According to the index of the blood stasis syndrome group, ET, NO and CRP have obvious line relationship with the blood stasis integral, P <0.05.(4) According to the stepwise regression analysis, the regression equation is blood stasis integral (y)=16.79+0.064xBT+0.063xNO+0.099xCRP, the variance analysis control is F=3.728, P<0.05.Conclusion:(1)morbidity of diabetic nephropathy's development to hemodialysis stage goes up gradually. Especially the high proportion of diabetic nephropathy in the blood stasis syndrome group announces that it may be one of the high-risk diseases which lead to blood stasis' formation of the maintenance hemodialysis patients.(2) More of the hemodialysis patients with blood stasis syndrome are blood stasis caused by qi deficiency.(3) Blood stasis syndrome can exist in different treatment stages of the maintenance hemodialysis with different degrees, and there is no obvious relationship with the patients'age and the term of hemodialysis.(4) blood stasis syndrome may be seen as the independent prognosis index, paralleling with indexes such as renal function, to evaluate the patients'prognosis.(5) Comparing with the non-blood stasis syndrome, the maintenance hemodialysis patients in blood stasis syndrome has obvious damage of their endothelial function. Consequently, ET and NO's content in blood serum may become the reference indicators for judging whether the hemodialysis patients have blood stasis syndrome or not. Therefoere, hemodialysis patients with the diagnosis of blood stasis and integral determination to help determine if patients with endothelial damage and platelet function, provides a theoretical basis for the use of the blood circulation of hemodialysis patients with concurrent treatment of thromboembolic disease.