Study On The Relationship Between Hypertension Complicated With Lacunar Cerebral Infarction And Cystatin C And Bilirubin In Different TCM Syndromes

Objective:To explore the correlation of Cys-C,TBIL,DBIL,IBIL and other indexes with EH combined with LI and TCM syndrome types,so as to provide a new idea for the early prevention and treatment of EH combined with LI and TCM syndrome differentiation.Method:A retrospective study was conducted to observe the clinical data of patients with EH complicated with LI.The general conditions(sex,age,height,weight),smoking history,drinking history,Cys-C,TBIL,DBIL,IBIL,hs-CRP,fasting blood glucose,blood lipids(TC,TG,HDL-C,LDL-C),uric acid,HCY indexes and four diagnostic information of EH inpatients who met the inclusion criteria were collected.According to the information collected,the patients with EH complicated with LI are divided into four TCM syndrome types.In addition,the patients with EH complicated with LI were divided into EH with LI group and EH without LI group(control group)according to the presence or absence of LI.The data were analyzed by SPSS24.0 statistical software to explore the correlation between the distribution of TCM syndrome types and physical and chemical indexes in patients with EH complicated with LI,and to explore the clinical markers of EH with LI.Results:1.The distribution of TCM syndromes in patients with EH complicated with LI is Yin deficiency of liver and kidney group(52)>middle obstruction of phlegm group(25)≥hyperactivity of liver yang group(25)>yin deficiency and yang hyperactivity group(18).The comparison of general data among the four groups showed that there were no significant differences in sex,age,BMI,course of hypertension,history of smoking,drinking history,blood pressure grade and risk stratification among different syndrome types(p>0.05).2.The distribution of Cys-C level in patients with different TCM syndrome types was in the following order:Yin deficiency of liver and kidney group>middle obstruction of phlegm group>yin deficiency and yang hyperactivity group>hyperactivity of liver yang group.The level of Cys-C in the group of stagnation of phlegm was higher than that in the group of hyperactivity of liver yang(P<0 05).3.There was significant difference in the level of TBIL among the four groups(P<0 05),which was in the following order:Yin deficiency of liver and kidney group>middle obstruction of phlegm group>hyperactivity of liver-yang group>yin deficiency and yang hyperactivity group.Pairwise comparison showed that the level of TBIL in the group of yin deficiency of liver and kidney was higher than that in the group of yin deficiency and yang hyperactivity(P<0 05).4.The level of IBIL in patients with different TCM syndrome types was different(P<0 05),which was in the following order:Yin deficiency of liver and kidney group>middle obstruction of phlegm group>hyperactivity of liver yang group>yin deficiency and yang hyperactivity group.5.Taking TCM syndrome type as dependent variable,multivariate logical regression analysis showed that yin deficiency and yang hyperactivity was negatively correlated with TBIL level,and the lower the TBIL level was,the greater the possibility of yin deficiency and yang hyperactivity was;the higher the level of TBIL and Cys-C was,the more inclined to the diagnosis of liver-kidney yin deficiency syndrome;the lower the Cys-C level was,the greater the possibility of liver-yang hyperactivity syndrome was.The higher the level of TBIL and Cys-C,the more inclined to the diagnosis of liver-kidney yin deficiency syndrome,and the lower the Cys-C level was,the greater the possibility of liver-yang hyperactivity syndrome was.6.Cys-C,age and course of hypertension were positively correlated with EH with LI(p<0.05),DBIL,UA,HCY were negatively correlated with EH with LI(p<0.05).It is suggested that age,Cys-C and course of hypertension are independent risk factors of EH with LI,while DBIL,UA and HCY are protective factors of EH with LI.Conclusions:1.Cys-C and DBIL were strongly correlated with EH combined with LI.2.The levels of TBIL,IBIL and Cys-C in patients with EH combined with LI were correlated with the evidence type,and the decreased level of TBIL was closely related to the evidence of Yin deficiency and Yang hyperactivity;the increased levels of TBIL and Cys-C were closely related to the evidence of Liver and Kidney Yin deficiency;the decreased level of Cys-C was closely related to the evidence of Liver Yang hyperactivity.