Analysis Of Related Risk Factors For HIV/AIDS Immunocompromising With Renal Damage And Study On TCM Syndrome Types

Objective To understand the incidence and influencing factors of renal damage in patients with HIV/AIDS immunodeficiency by cross-sectional survey of clinical characteristics of patients with HIV/AIDS immunodeficiency,and to study the dialectical classification of traditional Chinese medicine,so as to provide the basis and basis for traditional Chinese medicine treatment of patients with HIV/AIDS immunodeficiency complicated with renal damage.Methods According to the inclusion criteria and exclusion criteria,303 patients with poor HIV/AIDS immune reconstruction from January 2021 to December 2021 in the outpatient department of the second department of infection in Hangzhou Xixi Hospital were selected.The information of patients’ name,gender,age,course of disease,route of transmission,marital status,complications and drug use,and laboratory indexes such as CD4+ T cell count,urinary microalbumin,Hb,ALB,Scr,BUN,β2-MG and CysC were collected.According to the diagnostic criteria of chronic kidney disease,patients with poor HIV/AIDS immune reconstruction were divided into renal damage group and control group,and the effects of the above factors on patients with poor HIV/AIDS immune reconstruction and renal damage were analyzed.At the same time,the TCM symptoms were investigated to understand the distribution of TCM syndrome differentiation.In this study,SPSS26.0 software was used to process and analyze the collected data.Results 1.Epidemiological characteristics:303 patients with poor HIV/AIDS immune reconstruction were included in this study.Male patients accounted for 95.7%,and female patients accounted for 4.3%.The age distribution was between 24 and 84.There were 59 cases（19.5%）in renal damage group and 244 cases（80.5%）in control group.2.The renal function indexes between the two groups were compared.The medians of BUN,β2-MG and CysC in the renal damage group were higher than those in the control group,and the differences between the two groups were statistically significant.The area under the receiver operating characteristic curve（ROC）of BUN,β2-MG and CysC were 0.679,0.719 and 0.718,respectively,all P<0.001.3.Single factor analysis showed that there were statistically significant differences in age,BMI,hypertension history,diabetes history,hyperlipidemia history,acute infection history,tenofovir（TDF）,Hb,ALB,TG,CRP and CD4+T lymphocytes between the two groups（P<0.05）.4.The statistically significant factors obtained through single factor analysis were used as independent variables for multivariate logistic regression analysis,and it was concluded that the use of TDF,hypoproteinemia,and low CD4+T cell levels were independent risk factors for HIV/AIDS immunocompromising with renal damage.5.303cases of HIV/AIDS immune reconstruction combined with renal damage in patients with traditional Chinese medicine syndrome mainly damp-heat syndrome99cases,accounting for32.7%;80 cases of spleen deficiency with dampness syndrome,accounting for 26.4%;64 cases of spleen-kidney yang deficiency syndrome,accounting for 21.1%;48 cases of spleen-kidney qi deficiency syndrome,accounting for 15.8%;blood stasis syndrome in 12 cases,accounting for 4.0%.Conclusion 1.The incidence of renal damage in HIV/AIDS patients with poor immune reconstruction is 19.5%,which should be paid more attention by clinical workers.Regular monitoring of renal function,early detection and early treatment can delay disease progression.2.BUN,β2-MG,CysC can predict renal damage more early than Scr and GFR when HIV/AIDS immunocompromises with renal damage.3.Hypertension history,use of TDF,hypoproteinemia,low CD4+T cell levels are independent risk factors for HIV/AIDS immune reconstruction with renal damage.4.Traditional Chinese medicine syndrome is given priority to with deficiency syndrome,the distribution of more syndromes are damp-heat syndrome,spleen deficiency with dampness syndrome and spleen kidney yang deficiency syndrome.