Study On The Differences Of Hcy, BIL And Blood Lipids In Arteriosclerosis Obliterans With Cold Vein Syndrome And Blood Stasis Syndrom

Background:Arteriosclerotic occlusive disease(ASO)is a chronic arterial ischemic disease.Atherosclerosis of large and medium-sized arteries throughout the body leads to plaque formation,causing luminal narrowing or occlusion as the main cause of its occurrence.Hypertension,diabetes,hyperlipidemia and smoking are high risk factors for developing ASO.In recent years,the incidence of ASO has been on the rise and tends to be younger.If it is missed or misdiagnosed at an early stage,once it progresses to the stage of limb gangrene,it will face the risk of amputation,which will seriously affect the work and life of patients.At present,Chinese medicine has accumulated rich experience in the prevention and treatment of ASO,and discriminatory treatment is the core feature of Chinese medicine.The lack of unified diagnostic criteria for ASO evidence has,to a certain extent,restricted the clinical promotion of Chinese medicine.Objective of the study:In this study,we investigated the differences in homocysteine(Hcy)and bilirubin(BIL)levels and related lipid indices in patients with ASO with Choroid Yin cold syndrome and blood stasis syndrome of vein,and explored the evidence characteristics of Choroid Yin cold syndrome and blood stasis syndrome of vein to provide an objective theoretical basis for the early assessment of the risk of ASO and the development trend of the disease,and to provide an objective clinical index for the assessment of the change of Chinese medical evidence in ASO.METHODS:The population for this study was drawn from patients with ASO who attended our outpatient and inpatient units from March 2019 to December 2022.A total of 127 patients with ASO were finally included according to the inclusion and exclusion criteria.The patients’names,genders,ages,symptoms,signs and other related data were collected at the first visit,and the ASO patients who met the inclusion criteria were divided into two groups with Choroid Yin cold syndrome and blood stasis syndrome of vein.The laboratory indices of the patients’ first examination after admission,i.e.homocysteine(Hcy),total bilirubin(TBIL),direct bilirubin(DBIL)and lipid-related indices were recorded.Two persons independently entered the relevant data into an Excel sheet,and observed the differences of TBIL,DBIL,Hcy levels and lipid-related indexes in ASO with Choroid Yin cold syndrome and blood stasis syndrome of vein by summarizing and statistically analyzing the relevant data,and compared and analyzed the clinical characteristics of Choroid Yin cold syndrome and blood stasis syndrome of vein.The relationship between Hcy,BIL and lipid-related indexes in ASO patients was analyzed to provide a preliminary basis for further in-depth study of the pathological mechanism of ASO.RESULTS:1.A total of 127 patients with ASO were enrolled in this study,61 in the group with Choroid Yin cold syndrome and 66 in the group with blood stasis syndrome of vein.2.General:There was a statistically significant difference in the distribution of the 127 ASO patients by gender in age groups,and more men than women smoked(P<0.05).There was no statistical difference in age,gender,smoking history,body mass index and related medical history between the patients in the group with Choroid Yin cold syndrome and blood stasis syndrome of vein(P>0.05).3.BIL levels:TBIL and DBIL were statistically different in the comparison of gender(P<0.05).TBIL levels were negatively correlated with age(P<0.05),DBIL and Hcy were not correlated with age(P>0.05).TBIL and DBIL levels were statistically different(P<0.05)in the comparison of Choroid Yin cold syndrome and blood stasis syndrome of vein.After avoiding the interference of confounding causes such as gender,age,hyperlipidemia and diabetes,TBIL and DBIL levels were still independently correlated with the two groups of evidence(P<0.05).4.Hcy levels:Hcy levels were statistically different(P<0.05)in the evidence of Choroid Yin cold syndrome and blood stasis syndrome of vein.After excluding the interference of confounding causes such as gender,age,hyperlipidemia and diabetes,Hcy levels were still independently associated with both groups of evidence(P<0.05).5.Blood lipid levels:High-density lipoprotein(HDL),apolipoprotein A1(ApoA1),and lipoprotein a(Lp(a))showed statistically significant differences in veins with Choroid Yin cold syndrome and blood stasis syndrome of vein(P<0.05).6.Relationship between Hcy,BIL and lipid indices:Correlation test analysis showed that in 127 ASO patients,TBIL was positively correlated with DBIL,negatively correlated with Hcy and Lp(a),and DBIL was negatively correlated with TC,TG,LDL,ApoB,Lp(a)and ApoB/ApoAl(P<0.05).Conclusion:1.ASO mostly develops in the middle-aged and elderly population,with a higher incidence in men than in women.Hypertension,diabetes,hyperlipidemia,and smoking are common risk factors for ASO.In women,there is an upward slope in prevalence at the age of 60-69 years.2.The expressions of TBIL,DBIL and Hcy levels were differential in the Choroid Yin cold syndrome group and in the blood stasis syndrome of vein group.After excluding the interference of confounding factors such as smoking and age,TBIL,DBIL and Hcy were still independently associated with the two evidence groups.Hcy levels were higher in the Choroid Yin cold syndrome group than in the blood stasis syndrome of vein group,and their TBIL and DBIL levels were lower than in the Choroid Yin cold syndrome group,suggesting that the degree of arterial injury in the blood stasis syndrome of vein group may be more severe than that in the Choroid Yin cold syndrome group.BIL and Hcy can be used as one of the objective indicators to assess the early disease trend of ASO.3.The HDL and ApoA1 levels in the blood stasis syndrome of vein group were lower than those in the Choroid Yin cold syndrome group,and the Lp(a)level in the blood stasis syndrome of vein group was higher than that in the Choroid Yin cold syndrome group.It was suggested that the degree of atherosclerosis may be more severe in the blood stasis syndrome of vein group than that in the Choroid Yin cold syndrome group,and its vascular protective component may be lower than that in the Choroid Yin cold syndrome group.4.The correlation results of BIL,Hcy and lipid indexes indicated that BIL was closely related to lipid-related indexes and that there might be an interaction effect of BIL and Hcy on the occurrence of ASO,which provided preliminary ideas for further experimental studies on the specific mechanism of the combined effect of BIL,Hcy and lipid-related indicators on ASO.