Study On The Characteristics Of TCM Syndromes And The Correlation Between TCM Syndromes And Serum Ferritin In CKD(Stage 3-5) Non-dialysis Patients With Chronic Heart Failure

ObjectiveThis study investigated non-dialytic chronic kidney disease(ND-CKD)(stage3-5)patients complicated with chronic heart failure(CHF)about the characteristics of traditional Chinese medicine(TCM)syndromes and the correlation between serum ferritin,to discuss the relationship between serum ferritin with the severity of the disease of ND-CKD(stage 3-5)patients complicated with CHF and TCM syndromes,so as to provide objective basis for the evaluation of disease degree and syndrome differentiation and treatment of TCM.MethodsThis experiment was a cross-section study,which included ND-CKD(stage 3-5)complicated with CHF.It collected data about patients’ age,gender,creatinine(Crea),blood urea nitrogen(BUN),serum ferritin(SF),creatine kinase isoenzyme-MB(CK-MB),creatine kinase(CK),hyper-sensitive troponin I(hs-Tn I)、Myoglobin(Myo),n-terminal pro-brain natriuretic peptide(NT-pro BNP),left ventricular ejection fraction(LVEF),left ventricular hypertrophy(LVH),left atrium enlargement,TCM syndrome type and so on.The above patients were classified by TCM syndromes and CKD stage.Through the comparison between groups and univariate correlation analysis,the correlation between serum ferritin and TCM syndrome type and the severity of the disease was determined.Results1.51 cases(42.1%)with spleen and kidney yang deficiency syndrome and 58cases(47.9%)with blood stasis syndrome were more common in patients with ND-CKD(stage 3-5)complicated with CHF;2.There were significant differences in SF level between CHF patients with ND-CKD(stage 3-5)and deficiency syndrome of TCM(P < 0.05).And The correlation between SF level and deficiency of spleen and kidney yang deficiency syndrome(r=-0.246,P=0.007)and blood stasis syndrome(r=-0.240,P=0.008).3.The results showed that NT-pro BNP,LVEF,CK-MB,Myo,SF were substantial related factors with different CKD stages in patients with ND-CKD(stage3-5)complicated with CHF(P < 0.05).4.The correlation analysis showed that the correlation between SF and Crea(r=-0.183,P=0.045),BUN(r=-0.270,P=0.003),NT-pro BNP(r=-0.293,P=0.001),left atrium enlargement(r=0.105,P=0.008),e GFR(r=0.198,P=0.03),LVEF(r=0.485,P=0.000)were statistically significant in patients with ND-CKD(stage 3-5)complicated with CHF.Conclusion1.The TCM syndrome types of ND-CKD(stage 3-5)complicated with CHF are mainly syndrome of deficiency of spleen and kidney yang and blood stasis,and SF has certain correlation with the distribution of syndrome of deficiency and syndrome of demonstration;2.BUN,Crea,e GFR,NT-pro BNP,LVEF,CK-MB,Myo and SF were related to the severity of ND-CKD(stage 3-5)complicated with CHF,in which the level of SF decreased gradually with the aggravation of the disease,negatively correlated with Crea,BUN and NT-pro BNP,and positively correlated with the distribution of left atrium enlargement,e GFR and LVEF,which can be used as a predictive index to judge the severity of ND-CKD with CHF(stage 3-5).